Clinical Recommendations for Perioperative Immunotherapy-induced Adverse Events in Patients with Non-small Cell Lung Cancer.

Jun NI; Miao Huang; Li Zhang; Nan WU; Chunxue Bai; Liang'an Chen; Jun Liang; Qian Liu; Jie Wang; Yilong WU; Fengchun Zhang; Shuyang Zhang; Chun Chen; Jun Chen; Wentao Fang; Shugeng Gao; Jian HU; Tao Jiang; Shanqing LI; Hecheng LI; Yongde Liao; Yang Liu; Deruo Liu; Hongxu Liu; Jianyang Liu; Lunxu Liu; Mengzhao Wang; Changli Wang; Fan Yang; Yue Yang; Lanjun Zhang; Xiuyi Zhi; Wenzhao Zhong; Yuzhou Guan; Xiaoxiao Guo; Chunxia HE; Shaolei LI; Yue LI; Naixin Liang; Fangliang LU; Chao LV; Wei LV; Xiaoyan SI; Fengwei Tan; Hanping Wang; Jiangshan Wang; Shi Yan; Huaxia Yang; Huijuan Zhu; Junling Zhuang; Minglei Zhuo

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Clinical Recommendations for Perioperative Immunotherapy-induced Adverse Events in Patients with Non-small Cell Lung Cancer.

Author: Jun NI ¹ ; Miao HUANG ² ; Li ZHANG ¹ ; Nan WU ² ; Chunxue BAI ³ ; Liang'an CHEN ⁴ ; Jun LIANG ⁵ ; Qian LIU ⁶ ; Jie WANG ⁷ ; Yilong WU ⁸ ; Fengchun ZHANG ¹ ; Shuyang ZHANG ¹ ; Chun CHEN ⁹ ; Jun CHEN ¹⁰ ; Wentao FANG ¹¹ ; Shugeng GAO ⁷ ; Jian HU ¹² ; Tao JIANG ¹³ ; Shanqing LI ¹ ; Hecheng LI ¹⁴ ; Yongde LIAO ¹⁵ ; Yang LIU ⁴ ; Deruo LIU ¹⁶ ; Hongxu LIU ¹⁷ ; Jianyang LIU ¹⁸ ; Lunxu LIU ¹⁹ ; Mengzhao WANG ¹ ; Changli WANG ²⁰ ; Fan YANG ²¹ ; Yue YANG ² ; Lanjun ZHANG ²² ; Xiuyi ZHI ²³ ; Wenzhao ZHONG ⁸ ; Yuzhou GUAN ¹ ; Xiaoxiao GUO ¹ ; Chunxia HE ¹ ; Shaolei LI ² ; Yue LI ¹ ; Naixin LIANG ¹ ; Fangliang LU ² ; Chao LV ² ; Wei LV ¹ ; Xiaoyan SI ¹ ; Fengwei TAN ⁷ ; Hanping WANG ¹ ; Jiangshan WANG ¹ ; Shi YAN ² ; Huaxia YANG ¹ ; Huijuan ZHU ¹ ; Junling ZHUANG ¹ ; Minglei ZHUO ²
Author Information

1. Peking Union Medical Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China.
2. Department of Thoracic Surgery, Peking University Cancer Hospital, Beijing 100142, China.
3. Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
4. The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
5. Peking University International Hospital, Beijing 102206, China.
6. Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China.
7. State Key Laboratory of Molecular Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
8. Department of Pulmonary Cancer, Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, China.
9. Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
10. Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin 300052, China.
11. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
12. Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
13. Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
14. Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
15. Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei 430022, China.
16. China-Japan Friendship Hospital, Beijing 100029, China.
17. Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang 110001, China.
18. Department of Thoracic Surgery-1, Jilin Cancer Hospital, Changchun 130012, China.
19. Department of Cardiovascular and Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
20. Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
21. Peking University People's Hospital, Beijing 100044, China.
22. Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
23. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Publication Type:Journal Article
Keywords: Clinical recommendation; Immune checkpoint inhibitor related adverse events; Lung neoplasms; Perioperative immunotherapy
From: Chinese Journal of Lung Cancer 2021;24(3):141-160
CountryChina
Language:Chinese
Abstract: BACKGROUND:Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE).
METHODS:This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE.
RESULTS:This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively.
CONCLUSIONS:Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.