MASCC2020临床实践建议-免疫检查点抑制剂的重度胃肠道和肝脏的毒性

2020-12-28 癌症支持疗法多国学会 Support Care Cancer . 2020 Dec;28

免疫相关不良事件（IRAE）影响胃肠道（GI）道和肝脏是当代免疫疗法的最常见和最严重的炎症毒性之一。结肠癌和或小肠（肠溶）结肠炎的炎症是单一最常见的GI IRAE，是延迟免疫疗法延迟的重要原因。这些G

中文标题：

英文标题：

Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of severe gastrointestinal and hepatic toxicities from checkpoint inhibitors

发布机构：

癌症支持疗法多国学会

发布日期：

2020-12-28

简要介绍：

免疫相关不良事件（IRAE）影响胃肠道（GI）道和肝脏是当代免疫疗法的最常见和最严重的炎症毒性之一。结肠癌和或小肠（肠溶）结肠炎的炎症是单一最常见的GI IRAE，是延迟免疫疗法延迟的重要原因。这些GI IRAES的严重程度可以根据威胁危及生命的并发症，包括穿孔和肝脏衰竭的令人无法症状。 Gi Iraes的频率和严重程度依赖于给出的特定免疫疗法，细胞毒性T淋巴细胞抗原（CTLA）-4 -4更容易诱导严重的GI IRAES而不是被编程的细胞死亡蛋白1（PD-1）或PD- 1配体（PD-L1），以及组合治疗，显示出肝脏的最高速率，特别是在肝脏中。迄今为止，我们对GI IRAES的适当诊断和管理有最小的预期数据，而建议基于回顾性数据和专家意见。虽然Gi Iraes的临床诊断是常见的，但活检是诊断免疫疗法诱导的小肠结肠炎和肝炎的金标准，并且可以在不包括竞争中发挥重要作用，尽管较少，但诊断和确保最佳管理。 GI IRAE通常响应高剂量皮质类固醇，尽管大部分患者需要二次免疫抑制。对于结肠炎，患有英屈吡嗪和与vedolizumab的整合素抑制的TNF-α阻断在皮质类固醇耐火病例中证明了高效。为低级GI IRAES提供了详细的指导方针。在制定更严重的毒性方面，通常建议使用GI专家的参与。本综述的目的是调查可用的文献，并提供专注于GI专家的管理建议。

相关资料下载：

GetToolGuiderByIdResponse(projectId=1, id=4e5631c0020e25e3, title=MASCC2020临床实践建议-免疫检查点抑制剂的重度胃肠道和肝脏的毒性, enTitle=Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of severe gastrointestinal and hepatic toxicities from checkpoint inhibitors, guiderFrom=Support Care Cancer . 2020 Dec;28, authorId=0, author=, summary=免疫相关不良事件（IRAE）影响胃肠道（GI）道和肝脏是当代免疫疗法的最常见和最严重的炎症毒性之一。结肠癌和或小肠（肠溶）结肠炎的炎症是单一最常见的GI IRAE，是延迟免疫疗法延迟的重要原因。这些G, cover=https://img.medsci.cn/2021325/1616684173901_2020535.jpg, journalId=0, articlesId=null, associationId=993, associationName=癌症支持疗法多国学会, associationIntro=MASCC是癌症支持疗法多国学会的缩写，是一涉及癌症支持疗法的多学科的国际性组织。成员来自各大洲的60多个国家。MASCC成立于1990年，该组织致力于对各期癌症病人支持疗法各个方面的研究及教育。MASCC的工作目标是通过研究及科学认识的交流，提高支持疗法的专业水平。, copyright=0, guiderPublishedTime=Mon Dec 28 00:00:00 CST 2020, originalUrl=, linkOutUrl=, content=<div class="bp3-card bp3-elevation-0 result-block" style="color: #182026;"> <div class="common-result"> <div class="general-result"> <p>免疫相关不良事件（IRAE）影响胃肠道（GI）道和肝脏是当代免疫疗法的最常见和最严重的炎症毒性之一。结肠癌和或小肠（肠溶）结肠炎的炎症是单一最常见的GI IRAE，是延迟免疫疗法延迟的重要原因。这些GI IRAES的严重程度可以根据威胁危及生命的并发症，包括穿孔和肝脏衰竭的令人无法症状。 Gi Iraes的频率和严重程度依赖于给出的特定免疫疗法，细胞毒性T淋巴细胞抗原（CTLA）-4 -4更容易诱导严重的GI IRAES而不是被编程的细胞死亡蛋白1（PD-1）或PD- 1配体（PD-L1），以及组合治疗，显示出肝脏的最高速率，特别是在肝脏中。迄今为止，我们对GI IRAES的适当诊断和管理有最小的预期数据，而建议基于回顾性数据和专家意见。虽然Gi Iraes的临床诊断是常见的，但活检是诊断免疫疗法诱导的小肠结肠炎和肝炎的金标准，并且可以在不包括竞争中发挥重要作用，尽管较少，但诊断和确保最佳管理。 GI IRAE通常响应高剂量皮质类固醇，尽管大部分患者需要二次免疫抑制。对于结肠炎，患有英屈吡嗪和与vedolizumab的整合素抑制的TNF-α阻断在皮质类固醇耐火病例中证明了高效。为低级GI IRAES提供了详细的指导方针。在制定更严重的毒性方面，通常建议使用GI专家的参与。本综述的目的是调查可用的文献，并提供专注于GI专家的管理建议。<button class="bp3-button bp3-minimal bp3-small" style="color: #182026;" title="朗读" type="button"></button></p> </div> </div> </div> <div class="external-translators" style="color: #182026;"> <div> </div> </div>, tagList=[TagDto(tagId=36163, tagName=免疫检查点抑制剂)], categoryList=[CategoryDto(categoryId=5, categoryName=肿瘤科, tenant=100), CategoryDto(categoryId=85, categoryName=指南&解读, tenant=100), CategoryDto(categoryId=21100, categoryName=达仁堂循证e学界, tenant=100)], articleKeywordId=0, articleKeyword=, articleKeywordNum=6, guiderKeywordId=36163, guiderKeyword=免疫检查点抑制剂, guiderKeywordNum=6, haveAttachments=1, attachmentList=null, guiderType=0, guiderArea=共识, guiderLanguage=1, guiderRegion=4, opened=0, paymentType=, paymentAmount=10, recommend=0, recommendEndTime=null, sticky=0, stickyEndTime=null, allHits=2411, appHits=114, showAppHits=0, pcHits=423, showPcHits=2297, likes=0, shares=20, comments=6, approvalStatus=1, publishedTime=Thu Mar 25 23:31:11 CST 2021, publishedTimeString=2020-12-28, pcVisible=1, appVisible=1, editorId=2020535, editor=qiushida2, waterMark=0, formatted=0, memberCards=[], isPrivilege=0, deleted=0, version=2, createdBy=null, createdName=qiushida2, createdTime=Thu Mar 25 22:56:40 CST 2021, updatedBy=2020535, updatedName=qiushida2, updatedTime=Tue Jan 02 17:23:04 CST 2024, courseDetails=[], otherVersionGuiders=[], isGuiderMember=false, ipAttribution=, attachmentFileNameList=[AttachmentFileName(sort=1, fileName=检查点抑制剂对重度胃肠道和肝脏的毒性.pdf)])

检查点抑制剂对重度胃肠道和肝脏的毒性.pdf

下载请点击：

评论区 (5)

#插入话题

插入图片

[GetPortalCommentsPageByObjectIdResponse(id=956900, encodeId=fe09956900aa, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/09/06/ce0813625e59b0ea3d4d7a1d217a17aa.jpg, createdBy=c07f5181118, createdName=看书学习听课, createdTime=Wed Apr 14 14:01:36 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953464, encodeId=55af953464cf, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b512377781, createdName=gaogao292, createdTime=Sat Apr 03 10:02:42 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951554, encodeId=8e699515547d, content=挺有意义的, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=22201522767, createdName=ywisyw0, createdTime=Sat Mar 27 09:25:00 CST 2021, time=2021-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951448, encodeId=cce895144878, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9375179251, createdName=146f27e0m16暂无昵称, createdTime=Fri Mar 26 20:07:34 CST 2021, time=2021-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951332, encodeId=f467951332dd, content=很详细。学习中, beContent=null, objectType=guider, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJFVrx9g8MmM5aFpzC4tMCkYjLydhfNdzF7GL4zb9YUrfFnJ72AzwDDPgVF9e01DcKtOoCtmYeBFw/132, createdBy=94621663918, createdName=凤九天, createdTime=Fri Mar 26 09:32:23 CST 2021, time=2021-03-26, status=1, ipAttribution=)]
2021-04-14 看书学习听课

学习

112 0
[GetPortalCommentsPageByObjectIdResponse(id=956900, encodeId=fe09956900aa, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/09/06/ce0813625e59b0ea3d4d7a1d217a17aa.jpg, createdBy=c07f5181118, createdName=看书学习听课, createdTime=Wed Apr 14 14:01:36 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953464, encodeId=55af953464cf, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b512377781, createdName=gaogao292, createdTime=Sat Apr 03 10:02:42 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951554, encodeId=8e699515547d, content=挺有意义的, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=22201522767, createdName=ywisyw0, createdTime=Sat Mar 27 09:25:00 CST 2021, time=2021-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951448, encodeId=cce895144878, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9375179251, createdName=146f27e0m16暂无昵称, createdTime=Fri Mar 26 20:07:34 CST 2021, time=2021-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951332, encodeId=f467951332dd, content=很详细。学习中, beContent=null, objectType=guider, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJFVrx9g8MmM5aFpzC4tMCkYjLydhfNdzF7GL4zb9YUrfFnJ72AzwDDPgVF9e01DcKtOoCtmYeBFw/132, createdBy=94621663918, createdName=凤九天, createdTime=Fri Mar 26 09:32:23 CST 2021, time=2021-03-26, status=1, ipAttribution=)]
2021-04-03 gaogao292

学习了

96 0
[GetPortalCommentsPageByObjectIdResponse(id=956900, encodeId=fe09956900aa, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/09/06/ce0813625e59b0ea3d4d7a1d217a17aa.jpg, createdBy=c07f5181118, createdName=看书学习听课, createdTime=Wed Apr 14 14:01:36 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953464, encodeId=55af953464cf, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b512377781, createdName=gaogao292, createdTime=Sat Apr 03 10:02:42 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951554, encodeId=8e699515547d, content=挺有意义的, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=22201522767, createdName=ywisyw0, createdTime=Sat Mar 27 09:25:00 CST 2021, time=2021-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951448, encodeId=cce895144878, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9375179251, createdName=146f27e0m16暂无昵称, createdTime=Fri Mar 26 20:07:34 CST 2021, time=2021-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951332, encodeId=f467951332dd, content=很详细。学习中, beContent=null, objectType=guider, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJFVrx9g8MmM5aFpzC4tMCkYjLydhfNdzF7GL4zb9YUrfFnJ72AzwDDPgVF9e01DcKtOoCtmYeBFw/132, createdBy=94621663918, createdName=凤九天, createdTime=Fri Mar 26 09:32:23 CST 2021, time=2021-03-26, status=1, ipAttribution=)]
2021-03-27 ywisyw0

挺有意义的

111 0
[GetPortalCommentsPageByObjectIdResponse(id=956900, encodeId=fe09956900aa, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/09/06/ce0813625e59b0ea3d4d7a1d217a17aa.jpg, createdBy=c07f5181118, createdName=看书学习听课, createdTime=Wed Apr 14 14:01:36 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953464, encodeId=55af953464cf, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b512377781, createdName=gaogao292, createdTime=Sat Apr 03 10:02:42 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951554, encodeId=8e699515547d, content=挺有意义的, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=22201522767, createdName=ywisyw0, createdTime=Sat Mar 27 09:25:00 CST 2021, time=2021-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951448, encodeId=cce895144878, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9375179251, createdName=146f27e0m16暂无昵称, createdTime=Fri Mar 26 20:07:34 CST 2021, time=2021-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951332, encodeId=f467951332dd, content=很详细。学习中, beContent=null, objectType=guider, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJFVrx9g8MmM5aFpzC4tMCkYjLydhfNdzF7GL4zb9YUrfFnJ72AzwDDPgVF9e01DcKtOoCtmYeBFw/132, createdBy=94621663918, createdName=凤九天, createdTime=Fri Mar 26 09:32:23 CST 2021, time=2021-03-26, status=1, ipAttribution=)]
2021-03-26 146f27e0m16暂无昵称

学习了

115 0
[GetPortalCommentsPageByObjectIdResponse(id=956900, encodeId=fe09956900aa, content=学习, beContent=null, objectType=guider, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/09/06/ce0813625e59b0ea3d4d7a1d217a17aa.jpg, createdBy=c07f5181118, createdName=看书学习听课, createdTime=Wed Apr 14 14:01:36 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953464, encodeId=55af953464cf, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9b512377781, createdName=gaogao292, createdTime=Sat Apr 03 10:02:42 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951554, encodeId=8e699515547d, content=挺有意义的, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=22201522767, createdName=ywisyw0, createdTime=Sat Mar 27 09:25:00 CST 2021, time=2021-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951448, encodeId=cce895144878, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9375179251, createdName=146f27e0m16暂无昵称, createdTime=Fri Mar 26 20:07:34 CST 2021, time=2021-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=951332, encodeId=f467951332dd, content=很详细。学习中, beContent=null, objectType=guider, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJFVrx9g8MmM5aFpzC4tMCkYjLydhfNdzF7GL4zb9YUrfFnJ72AzwDDPgVF9e01DcKtOoCtmYeBFw/132, createdBy=94621663918, createdName=凤九天, createdTime=Fri Mar 26 09:32:23 CST 2021, time=2021-03-26, status=1, ipAttribution=)]
2021-03-26 凤九天

很详细。学习中

99 0

内科

外科

专科科室

热点

按科室浏览

临床工具

科研工具

其他工具

科研数智化

真实世界研究解决方案

数字化学术传播解决方案

其它

肿瘤科指南

MASCC2020临床实践建议-免疫检查点抑制剂的重度胃肠道和肝脏的毒性

相关指南

拓展阅读

科室

工具

服务