个体化文章：NECOM 4：一种整合护肤的算法，用于管理癌症患者和幸存者的免疫治疗相关皮肤不良反应。

INDIVIDUAL ARTICLE: NECOM 4: Algorithm Integrating Skincare for the Management of Immunotherapy-Related Cutaneous Adverse Events for Cancer Patients and Survivors.

出版信息

J Drugs Dermatol. 2024 Aug 1;23(8):85411s3-85411s10. doi: 10.36849/JDD.85411.

Abstract

BACKGROUND

In the Nordic European Countries, cancer is the leading cause of death. The last decade has brought revolutionizing cancer treatments including immune checkpoint inhibitors (ICIs). Patients on ICIs have a high risk of developing cutaneous immune-related adverse events. Treating these side effects is of high importance to improve patient's quality of life (QoL) and continue the anti-cancer treatment.

METHODS

The Nordic European Cutaneous Oncodermatology Management (NECOM) project develops tools to prevent and treat cancer therapy-related cutaneous adverse events (cAEs). The first 2 NECOM papers presented various cAEs and skincare regimens involving hygiene, moisturization, sun protection, and camouflage products for preventing and managing cAEs. The NECOM 3 practical algorithm was on the prevention and treatment of acute radiation dermatitis. This NECOM 4 practical algorithm is intended to prevent and manage cutaneous immunotherapy-related adverse events (cirAEs), improving cancer patients' QoL and outcomes.

RESULTS

The NECOM advisors discussed the results of a systematic literature review and obtained consensus on the evidence and expert opinion-based practical algorithm for cirAEs to support all healthcare providers treating cancer patients in the Nordic European Countries. The algorithm starts with a simple skincare regimen of cleansing, moisturizing, and protection, followed by the exclusion of severe cutaneous adverse reactions, and then specific interventions to treat the most common cirAEs (pruritus, maculopapular eruption, eczematous eruption, psoriasis, lichenoid eruption, and bullous eruption).

CONCLUSIONS

CirAEs are the most common side effects induced by ICIs and may lead to cancer treatment interruption or even discontinuation. Patient education on the prevention of cirAEs using a skincare regimen and treatment recommendations given in the NECOM 4 algorithm may help prevent and manage cirAEs and improve the QoL and outcome of patients receiving ICIs. J Drugs Dermatol. 2024;23:8(Suppl 2):s4-10.

摘要

背景

在北欧国家，癌症是导致死亡的主要原因。过去十年带来了癌症治疗的革命性进展，包括免疫检查点抑制剂（ICI）。接受 ICI 治疗的患者发生皮肤免疫相关不良事件的风险很高。治疗这些副作用对于提高患者的生活质量（QoL）并继续癌症治疗非常重要。

方法

北欧皮肤肿瘤管理（NECOM）项目开发了预防和治疗癌症治疗相关皮肤不良事件（cAEs）的工具。前两篇 NECOM 论文介绍了各种 cAEs 和皮肤护理方案，包括预防和管理 cAEs 的卫生、保湿、防晒和伪装产品。NECOM 3 实用算法是关于急性放射性皮炎的预防和治疗。本 NECOM 4 实用算法旨在预防和管理皮肤免疫治疗相关不良事件（cirAEs），提高癌症患者的 QoL 和结局。

结果

NECOM 顾问讨论了系统文献综述的结果，并就 cirAEs 的循证和基于专家意见的实用算法达成共识，以支持北欧国家治疗癌症患者的所有医疗保健提供者。该算法从简单的皮肤护理方案开始，包括清洁、保湿和保护，然后排除严重的皮肤不良反应，然后针对最常见的 cirAEs（瘙痒、斑丘疹、湿疹样疹、银屑病、苔藓样疹和大疱性疹）进行具体干预。

结论

cirAEs 是 ICI 诱导的最常见副作用，可能导致癌症治疗中断甚至停止。使用皮肤护理方案对 cirAEs 进行预防教育，并在 NECOM 4 算法中给出治疗建议，可能有助于预防和管理 cirAEs，提高接受 ICI 治疗的患者的 QoL 和结局。J 皮肤病药物杂志。2024;23:8（增刊 2）：s4-10。