Londoño Maria-Carlota, Reig Maria
Liver Unit, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, CIBERehd, 08036 Barcelona, Spain.
Liver Liver Cancer Group (BCLC), Liver Unit, Hospital Clínic Barcelona, IDIBAPS, University of Barcelona, CIBERehd, 08036 Barcelona, Spain.
Cancers (Basel). 2020 Nov 19;12(11):3446. doi: 10.3390/cancers12113446.
Immune-oncology is a major breakthrough in cancer treatment and has become the standard of care for a wide variety of solid organ malignancies. Unfortunately, manipulation of the immune system with checkpoint inhibitors may result in an immune-based attack of normal tissues which can lead to treatment discontinuation. These immune-related adverse events (irAEs) are diverse and affect several organs, constituting a new clinical challenge in the management of cancer patients. The complexity of this scenario requires a multidisciplinary approach that allows the early identification, diagnosis and treatment of specific irAE, ruling out other non-related adverse events. Hospital Clinic has a multidisciplinary team seeking to develop a coordinated strategy to facilitate the access of patients with suspected irAEs to specialised care resulting in harmonised management that guarantees the best patient care. The aim of the manuscript was to describe the current evidence on the management of irAEs reflecting a coordinated multidisciplinary approach to face this clinical challenge regardless of the immunotherapy indication.
免疫肿瘤学是癌症治疗的一项重大突破,已成为多种实体器官恶性肿瘤的标准治疗方法。不幸的是,使用检查点抑制剂操纵免疫系统可能会导致对正常组织的免疫攻击,从而导致治疗中断。这些免疫相关不良事件(irAE)多种多样,会影响多个器官,构成了癌症患者管理中的一项新的临床挑战。这种情况的复杂性需要一种多学科方法,以便早期识别、诊断和治疗特定的irAE,排除其他无关的不良事件。巴塞罗那大学附属医院有一个多学科团队,旨在制定一项协调战略,以方便疑似发生irAE的患者获得专科护理,从而实现统一管理,确保为患者提供最佳护理。本文的目的是描述关于irAE管理的当前证据,反映出一种协调的多学科方法,以应对这一临床挑战,而不考虑免疫治疗的适应症。