定义D-irAEs:基于共识的疾病定义,用于诊断来自免疫检查点抑制剂治疗的皮肤不良事件
Steven T Chen1,2,3, Yevgeniy R Semenov1,3, Allireza Alloo4
1Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Journal for immunotherapy of cancer
|April 10, 2024
概括
皮肤免疫相关的不良事件 (D-irAEs) 在癌症免疫疗法中很常见. 这项研究建立了10个D-irAEs的共识定义,以改善诊断和未来的研究.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
- 临床研究 临床研究
背景情况:
- 免疫检查点抑制剂 (ICI) 的使用越来越多,导致免疫相关不良事件 (irAEs) 的增加.
- 皮肤性激发性疹 (D-irAEs) 是最常见和最早的激发性疹,影响患者管理.
- 目前对D-irAEs的诊断标准缺乏明确性,阻碍了一致的识别和研究.
研究的目的:
- 为D-irAEs的定义和严重程度分级制定共识指南.
- 为关键的D-irAEs建立标准化的诊断标准.
- 为临床和研究环境创建一个可用的框架.
主要方法:
- 一个经过修改的Delphi共识过程,涉及34名专家 (瘤学家,皮肤学家,风湿学家,过敏学家/免疫学家).
- 两轮匿名电子调查,使用9分评级表和虚拟会议讨论争议.
- 达成共识的定义是基于RAND/UCLA适当性方法.
主要成果:
- 在10个核心D-irAE诊断方面达成共识,包括ICI-白,ICI-平,ICI-牛皮,ICI-,ICI-,ICI-,ICI-爆发性非典型状增殖,ICI-无皮疹,ICI-侵蚀性粘膜皮质.
- 还建立了D-irAEs的标准评估方法,并指出了特定疾病的例外情况.
- 每个定义包括亚型,症状,检查结果和诊断确定性水平 (确定的,可能的,可能的).
结论:
- 基于共识的定义将D-irAE分类标准化为多个学科可用的框架.
- 这些定义为未来对D-irAEs的研究和临床研究提供了基础.
- 已建立的定义预计将在临床和研究环境中广泛使用,因为其已证明的准确性和可用性.
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