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癌症免疫治疗学会(SITC)免疫检查点抑制剂相关免疫相关不良事件(irAEs)术语的共识定义。

Society for Immunotherapy of Cancer (SITC) consensus definitions for immune checkpoint inhibitor-associated immune-related adverse events (irAEs) terminology.

机构信息

Oncology, Beaumont RCSI Cancer Centre, Dublin, Ireland

RCSI university of Health Sciences, Beaumont RSCI Cancer Centre, Dublin, Ireland.

出版信息

J Immunother Cancer. 2023 Mar;11(3). doi: 10.1136/jitc-2022-006398.

Abstract

Immune-related adverse events (irAEs) associated with immune checkpoint inhibitor (ICI) therapy may vary substantially in their clinical presentation, including natural history, outcomes to treatment, and patterns. The application of clinical guidelines for irAE management can be challenging for practitioners due to a lack of common or consistently applied terminology. Furthermore, given the growing body of clinical experience and published data on irAEs, there is a greater appreciation for the heterogeneous natural histories, responses to treatment, and patterns of these toxicities, which is not currently reflected in irAE guidelines. Furthermore, there are no prospective trial data to inform the management of the distinct presentations of irAEs. Recognizing a need for uniform terminology for the natural history, response to treatment, and patterns of irAEs, the Society for Immunotherapy of Cancer (SITC) convened a consensus panel composed of leading international experts from academic medicine, industry, and regulatory agencies. Using a modified Delphi consensus process, the expert panel developed clinical definitions for irAE terminology used in the literature, encompassing terms related to irAE natural history (ie, re-emergent, chronic active, chronic inactive, delayed/late onset), response to treatment (ie, steroid unresponsive, steroid dependent), and patterns (ie, multisystem irAEs). SITC developed these definitions to support the adoption of a standardized vocabulary for irAEs, which will have implications for the uniform application of irAE clinical practice guidelines and to enable future irAE clinical trials.

摘要

免疫相关不良事件(irAE)与免疫检查点抑制剂(ICI)治疗相关,其临床表现可能存在很大差异,包括自然病史、治疗结果和模式。由于缺乏通用或一致应用的术语,临床指南在 irAE 管理中的应用可能对从业者构成挑战。此外,鉴于 irAE 的临床经验和已发表数据不断增加,人们越来越认识到这些毒性的异质性自然病史、对治疗的反应和模式,这在目前的 irAE 指南中并未得到体现。此外,没有前瞻性试验数据可以为 irAE 不同表现的管理提供信息。为了统一 irAE 的自然病史、治疗反应和模式的术语,癌症免疫治疗学会(SITC)召集了一个由来自学术医学、工业和监管机构的领先国际专家组成的共识小组。使用改良 Delphi 共识过程,专家组为文献中使用的 irAE 术语制定了临床定义,涵盖与 irAE 自然病史相关的术语(即重新出现、慢性活跃、慢性不活跃、延迟/后期发作)、对治疗的反应(即对类固醇无反应、对类固醇依赖)和模式(即多系统 irAE)。SITC 制定这些定义是为了支持采用 irAE 的标准化词汇,这将对 irAE 临床实践指南的统一应用产生影响,并为未来的 irAE 临床试验提供支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec28/10069596/04cc5dcd1691/jitc-2022-006398f01.jpg

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