肿瘤细胞治疗研究
英文原题：Tumor inflammation-associated neurotoxicity.
肿瘤免疫治疗具有独特的毒性。
癌症免疫疗法具有独特毒性。建立毒性综合征分级标准和标准化分级治疗流程，可提高治疗安全性；CAR-T治疗B细胞恶性肿瘤中的CRS和ICANS管理已体现这一点。作者观察到，中枢神经系统（CNS）肿瘤患者接受细胞疗法后会出现一种不同于CRS和ICANS的毒性综合征，称为肿瘤炎症相关神经毒性（TIAN）。TIAN涵盖“假性进展”概念，但范围不限于炎症所致水肿；它不仅适用于细胞疗法，也与其他CNS肿瘤免疫疗法相关。为促进CNS肿瘤患者安全接受细胞治疗，本文界定TIAN，提出其毒性分级标准并讨论潜在管理方法，以推动报告和处理标准化。
Cancer immunotherapies have unique toxicities. Establishment of grading scales and standardized grade-based treatment algorithms for toxicity syndromes can improve the safety of these treatments, as observed for cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS) in patients with B cell malignancies treated with chimeric antigen receptor (CAR) T cell therapy. We have observed a toxicity syndrome, distinct from CRS and ICANS, in patients treated with cell therapies for tumors in the central nervous system (CNS), which we term tumor inflammation-associated neurotoxicity (TIAN). Encompassing the concept of 'pseudoprogression,' but broader than inflammation-induced edema alone, TIAN is relevant not only to cellular therapies, but also to other immunotherapies for CNS tumors. To facilitate the safe administration of cell therapies for patients with CNS tumors, we define TIAN, propose a toxicity grading scale for TIAN syndrome and discuss the potential management of this entity, with the goal of standardizing both reporting and management.
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