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Evidence-based expert consensus on clinical management of safety of Bruton’s tyrosine kinase inhibitors(2024)

chinese Journal of cancer Research 2024年第3期36卷 240-256页

作者： Zaiwei Song Dan Jiang Lingling Yu Yixuan Chen Daobin Zhou Yue Li Depei Wu Lingli Zhang Liyan Miao Jun Ma Jun Zhu Hongmei Jing Rongsheng Zhao the Steering committee,the Consensus Panel and the Evidence Synthesis Group Evidence-based Pharmacy Professional committee of chinese Pharmaceutical association(CPA) Hospital Pharmacy Professional committee of chinese Pharmaceutical association(CPA) Division of Therapeutic Drug Monitoring of chinese Pharmacological society(CPS) Expert committee on Lymphoma of chinese society of Clinical Oncology(CSCO) Expert committee on Leukemia of chinese society of Clinical Oncology(CSCO) society of Integrative Cardio-Oncology of China anti-cancer association(CACA) chinese society of Hematology of chinese Medical association(CMA) Hospital Pharmacy Professional committee of Cross-Straits Medicine Exchange association(SMEA) Department of Pharmacy Peking University Third HospitalBeijing 100191China Institute for Drug Evaluation Peking University Health Science CenterBeijing 100191China Therapeutic Drug Monitoring and Clinical Toxicology Center Peking UniversityBeijing 100191China Department of Pharmacy Administration and Clinical Pharmacy School of Pharmaceutical SciencesPeking UniversityBeijing 100191China Department of Hematology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100005China Department of Cardiology the First Affiliated HospitalHarbin Medical UniversityHarbin 150001China Department of Hematology the First Affiliated Hospital of Soochow UniversitySuzhou 215006China Department of Pharmacy Evidence-based Pharmacy CenterWest China Second HospitalSichuan UniversityChengdu 610041China Department of Pharmacy the First Affiliated Hospital of Soochow UniversitySuzhou 215006China Department of Hematology and Oncology Harbin Institute of Hematology and OncologyHarbin 150010China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of LymphomaPeking University Cancer Hospital&InstituteBeijing 100142China Department of Hematology Peking University Third HospitalBeijing 100191China 不详

Bruton’s tyrosine kinase inhibitors(BTKis)have revolutionized the treatment of B-cell ***,safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy.A comprehensive and systematic expert consensus from a pharmacological perspective is lacking for safety issues associated with BTKi treatment.A multidisciplinary consensus working group was established,comprising 35 members from the fields of hematology,cardiovascular disease,cardio-oncology,clinical pharmacy,and evidencebased *** evidence-based expert consensus was formulated using an evidence-based approach and the Delphi *** Joanna Briggs Institute Critical Appraisal(JBI)tool and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach were used to rate the quality of evidence and grade the strength of recommendations,*** consensus provides practical recommendations for BTKis medication based on nine aspects within three domains,including the management of common adverse drug events such as bleeding,cardiovascular events,and hematological toxicity,as well as the management of drug-drug interactions and guidance for special *** multidisciplinary expert consensus could contribute to promoting a multi-dimensional,comprehensive and standardized management of BTKis.

关键词： Consensus BTK inhibitors safety adverse drug events drug-drug interactions

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Clinical practice guidelines for full-cycle standardized management of bone health in breast cancer patients

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cancer Innovation 2024年第1期3卷 1-28页

作者： committee of Full-cycle Standardized Management of Bone Health in breast cancer Patients Fei Ma 不详 Department of Medical Oncology National Cancer CenterNational Clinical Research Center for CancerCancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

Bone health management for breast cancer spans the entire cycle of patient care,including the prevention and treatment of bone loss caused by early breast cancer treatment,the adjuvant application of bone-modifying agents to improve prognosis,and the diagnosis and treatment of advanced bone *** good bone health management means formulating appropriate treatment strategies and dealing with adverse drug reactions,and will help to improve patients'quality of life and survival *** breast cancer Expert committee of the National cancer Center for Quality Control organized relevant experts to conduct an in-depth discussion on the full-cycle management of breast cancer bone health based on evidence-based medicine,and put forward reasonable suggestions to guide clinicians to better deal with health issues in bone health clinics.

关键词： bone health bone-modifying drugs breast cancer guidelines

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chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation

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Journal of Geriatric Cardiology 2024年第3期21卷 251-314页

作者： Chang-Sheng MA Shu-Lin WU Shao-Wen LIU Ya-Ling HAN chinese society of Cardiology chinese Medical association Heart Rhythm committee of chinese society of Biomedical Engineering Beijing Anzhen Hospital Capital Medical University Guandong Provincial People’s Hospital Shanghai First People’s Hospital General Hospital of Northern Theater Command 不详

Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia,significantly impacting patients’quality of life and increasing the risk of death,stroke,heart failure,and *** the past two decades,there have been significant breakthroughs in AF risk prediction and screening,stroke prevention,rhythm control,catheter ablation,and integrated *** this period,the scale,quality,and experience of AF management in China have greatly improved,providing a solid foundation for the development of guidelines for the diagnosis and management of *** further promote standardized AF management,and apply new technologies and concepts to clinical practice in a timely and comprehensive manner,the chinese society of Cardiology of the chinese Medical association and the Heart Rhythm committee of the chinese society of Biomedical Engineering have jointly developed the chinese Guidelines for the Diagnosis and Management of Atrial *** guidelines have comprehensively elaborated on various aspects of AF management and proposed the CHA2DS2-VASc-60 stroke risk score based on the characteristics of AF in the Asian *** guidelines have also reevaluated the clinical application of AF screening,emphasized the significance of early rhythm control,and highlighted the central role of catheter ablation in rhythm control.

关键词： prevention sustained diagnosis

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中西医整合乳腺癌长期用药专家共识

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中华肿瘤防治杂志 2024年第13期31卷 785-799页

作者：朱世杰陈武进中国抗癌协会中西医整合乳腺癌专业委员会中国中医科学院望京医院福建中医药大学附属人民医院

随着乳腺癌患者总生存期(OS)的延长，乳腺癌长期用药问题引起了广泛的关注。然而，目前尚未有相关指南和共识针对乳腺癌患者中西医整合长期用药问题进行较为全面的指导和规范。中国抗癌协会中西医整合乳腺癌专业委员会专门针对乳腺癌中... 详细信息

随着乳腺癌患者总生存期(OS)的延长，乳腺癌长期用药问题引起了广泛的关注。然而，目前尚未有相关指南和共识针对乳腺癌患者中西医整合长期用药问题进行较为全面的指导和规范。中国抗癌协会中西医整合乳腺癌专业委员会专门针对乳腺癌中西医整合长期用药问题召开了3次研讨会，并最终制定了本共识。旨在进一步提高乳腺癌患者长期用药依从性，使患者能够达到有效的药物使用时长，并提高患者生活质量、延长OS。

关键词：乳腺肿瘤长期用药整合医学中西医整合专家共识

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Expert consensus on radiotherapy combined with immunotherapy for esophageal cancer(2024 edition)

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Radiation Medicine and Protection 2024年第2期5卷 59-67页

作者： Professional committee of Radiation Oncology China anti-cancer association Branch of Radiation Oncology chinese Medical association Branch of Radiation Oncology TreatmentPhysician chinese Medical Doctor association Qingsong Pang Jun Wang Zhouguang Hui Wencheng Zhang 不详 Tianjin Medical University cancer Institute&Hospital Tianjin 300060China the Fourth Hospital of Hebei Medical University Shijiazhuang 050011China National cancer Center National Clinical Research Center for CancerCancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Tianjin Medical University cancer Hospital China

Radiotherapy represents an essential treatment approach for esophageal *** recent years,immunotherapy combined with chemotherapy has become the first-line standard treatment for patients with advanced esophageal *** phase III studies on immunotherapy combined with radiotherapy for locally advanced esophageal cancer are currently *** evidence-based medical data are urgently needed to support the integration of immunotherapy and chemoradiotherapy as a new treatment strategy for patients with locally advanced esophageal *** consensus,formulated based on the latest study results,in-depth research,and thorough discussions,provides a comprehensive set of *** document extensively covers treatment strategies and evaluation methods for radiotherapy combined with immunotherapy across patients with operable esophageal cancer,inoperable locally advanced esophageal cancer,and advanced esophageal ***,common complications and radiation-related issues associated with radiotherapy combined with immunotherapy are discussed,serving as clinical *** expert group comprised members from the Professional committee of Radiation Oncology,China anti-cancer association,the Branch of Radiation Oncology,chinese Medical association,and the Branch of Radiation Oncology Treatment Physician,chinese Medical Doctor association.

关键词： Esophageal squamous cell carcinoma Esophageal adenocarcinoma Immunotherapy Chemoradiotherapy Radiotherapy Expert consensus

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chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation

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Cardiology Discovery 2024年第2期4卷 89-133页

作者：无 Changsheng Ma Shulin Wu Shaowen Liu Yaling Han chinese society of Cardiology Chinese Medical Association Heart Rhythm committee of chinese society of Biomedical Engineering 不详

Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia,significantly impacting patients'quality of life and increasing the risk of death,stroke,heart failure,and *** the past 2 decades,there have been significant breakthroughs in AF risk prediction and screening,stroke prevention,rhythm control,catheter ablation,and integrated *** this period,the scale,quality,and experience of AF management in China have greatly improved,providing a solid foundation for the development of guidelines for the diagnosis and management of *** further promote standardized AF management,and apply new technologies and concepts to clinical practice in a timely and comprehensive manner,the chinese society of Cardiology of the chinese Medical association and the Heart Rhythm committee of the chinese society of Biomedical Engineering have jointly developed the chinese Guidelines for the Diagnosis and Management of Atrial *** guidelines have comprehensively elaborated on various aspects of AF management and proposed the CHA,DS,-VASc-60 stroke risk score based on the characteristics of AF in the Asian *** guidelines have also reevaluated the clinical application of AF screening,emphasized the significance of early rhythm control,and highlighted the central role of catheter ablation in rhythm control.

关键词： Atrial fibrillation anticoagulation Rhythm control Catheter ablation Integrated management Guideline

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中国早期乳腺癌卵巢功能抑制临床应用专家共识(2024年版)

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中国癌症杂志 2024年第3期34卷 316-334页

作者：中国抗癌协会乳腺癌专业委员会胡夕春吴炅任国胜江泽飞张瑾张剑不详复旦大学附属肿瘤医院肿瘤内科复旦大学附属肿瘤医院乳腺外科重庆医科大学附属第一医院乳腺甲状腺外科中国人民解放军总医院肿瘤医学部肿瘤内科天津医科大学肿瘤医院乳腺外科

中国乳腺癌患者发病年龄较轻,60%的女性患者在诊断时为绝经前。与绝经后相比,未绝经女性卵巢功能旺盛,可持续大量分泌雌激素、促进乳腺癌细胞增殖。卵巢功能抑制(ovarian function suppression,OFS)已用于乳腺癌临床治疗数十年,大量循... 详细信息

中国乳腺癌患者发病年龄较轻,60%的女性患者在诊断时为绝经前。与绝经后相比,未绝经女性卵巢功能旺盛,可持续大量分泌雌激素、促进乳腺癌细胞增殖。卵巢功能抑制(ovarian function suppression,OFS)已用于乳腺癌临床治疗数十年,大量循证证据表明,单用OFS和加用OFS均可降低未绝经女性乳腺癌的复发风险并改善生存。部分OFS研究的长期随访数据(SOFT/TEXT研究12和13年随访、STO-5研究20年随访、亚裔人群的ASTRRA研究8年随访)近期陆续公布,进一步证实对于早期乳腺癌患者加用OFS可显著降低10年以上的复发风险,提高治愈可能。monarchE和NATALEE研究显示,部分CDK4/6抑制剂叠加在绝经前早期乳腺癌患者含有药物去势[促性腺激素释放激素类似物(gonadotropin releasing hormone analog,GnRHa)]的辅助内分泌治疗方案时仍可进一步增加生存获益。中国抗癌协会乳腺癌专业委员会召集了国内乳腺癌治疗领域的临床专家,在2021年版的基础上共同商讨编制了《中国早期乳腺癌卵巢功能抑制临床应用专家共识(2024年版)》。本共识建议,GnRHa仍作为绝经前激素受体阳性早期乳腺癌OFS方式的首选。GnRHa联合内分泌治疗基础上添加特定CDK4/6抑制剂的激素受体阳性绝经前乳腺癌获益人群包括:淋巴结阳性,淋巴结阴性且满足任一条件[G3,G2伴Ki-67增殖指数≥20%,G2伴多基因检测(21基因评分、Prosigna PAM50、MammaPrint、EndoPredict)高危]。本共识也认可将2023年***共识中有化疗指征的风险因素作为OFS适用判定标准之一。GnRHa用药推荐根据激素受体阳性乳腺癌患者化疗前的卵巢功能状态进行决策。如果考虑卵巢保护,推荐GnRHa同步化疗,不影响患者生存获益;如果不考虑卵巢保护,GnRHa同步化疗和GnRHa在化疗结束后序贯使用均被认可,后者更为推荐。围绝经期患者的内分泌治疗建议参照绝经前方案。GnRHa辅助内分泌治疗的时长建议为5年。中高危患者完成5年联合GnRHa的内分泌治疗后,如果未绝经且耐受性良好,可考虑继续2~5年联合GnRHa的内分泌治疗或单用2~5年选择性雌激素受体调节剂(selective estrogen receptor modulator,SERM)治疗。辅助治疗方案中添加GnRHa安全可耐受,推荐应用前和患者充分沟通药物的使用方法和可能的不良事件,安全性管理有助于提高患者的依从性。对于接受药物去势的患者,在去势过程中不推荐常规监测雌激素水平,如怀疑不完全的OFS(包括改变用法如注射人员缺乏该药物熟练注射经验、更换剂型或出现某些可能提示卵巢功能恢复的生理变化如月经恢复或更年期症状的周期性波动时),可进行雌激素水平测定以辅助决策。绝经前乳腺癌患者如有需求,无论激素受体阳性或阴性,均可使用GnRHa保护卵巢功能,降低卵巢功能早衰的发生风险,减少生育能力损害,推荐化疗前至少1周开始使用GnRHa,每28 d 1次,直至化疗结束后2周给予最后1剂。针对激素受体阳性乳腺癌患者开展的临床试验,不推荐仅纳入绝经后人群,也应当探索GnRHa应用条件下的绝经前人群,以明确试验药物对这类患者的实际效应。另外本共识还新增了早期/局部晚期乳腺癌患者OFS药物应用的全程管理路径,以期进一步助力临床决策。

关键词：乳腺癌卵巢功能抑制专家共识

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Stress Echocardiography for Chronic Coronary Syndrome:Clinical Practice Guidelines(2023)

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Journal of Geriatric Cardiology 2024年第5期21卷 475-505页

作者： Peng-Fei ZHANG Jia-Wei TIAN Tian-Gang ZHU Jue-Fei WU Xiao-Ping LENG Yi WANG Meng-Meng LI Xin-Hao LI Qian-Qian WANG Xiao-Peng FENG Jia-Yan LV Li-Xue YIN Yun ZHANG Mei ZHANG chinese society of Echocardiography,Superficial Tissue and Vascular Group of chinese society of Ultrasound in Medicine,Ultrasound Professional committee of chinese Medicine Education association State Key Laboratory for Innovation and Transformation of Luobing Theory Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese National Health Commission and Chinese Academy of Medical SciencesDepartment of CardiologyQilu Hospital of Shandong UniversityJinanChina The Second Affiliated Hospital of Harbin Medical University HaerbinChina Peking University People's Hospital BeijingChina Sichuan Province People's Hospital ChengduChina Nanfang Hospital Southern Medical UniversityGuangzhouChina Peking Union Medical College Hospital Chinese Academy of Medical SciencesBeijingChina 不详

In the context of the People's Republic of China,coronary artery disease(CAD)presents a sig-nificant clinical challenge,with over 11.3 mil-lion patients ***,the diagnos-is of CAD has predominantly relied on invasive coronary angiography.[1]However,recent advances in clinical research have revealed a notable trend:a substantial 82% of patients subjected to such invas-ive diagnostics do not necessitate interventional therapy.

关键词： coronary clinical patients

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骨改良药物用于恶性肿瘤骨转移治疗的安全性共识(2024版)

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中华肿瘤杂志 2024年第7期46卷 637-645页

作者：中国医师协会肿瘤医师分会乳腺癌学组中国抗癌协会国际医疗交流分会袁芃徐兵河王雪不详国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院特需医疗部北京100021

骨改良药物是一类缓解因骨转移引起的疼痛、病理性骨折、脊髓压迫、高钙血症等一系列骨相关事件药物的总称,目前包括双膦酸盐和RANKL抑制剂。由于骨改良药物广泛应用,其药物的不良反应逐渐增多,并影响患者的生活质量。中国医师协会肿瘤... 详细信息

骨改良药物是一类缓解因骨转移引起的疼痛、病理性骨折、脊髓压迫、高钙血症等一系列骨相关事件药物的总称,目前包括双膦酸盐和RANKL抑制剂。由于骨改良药物广泛应用,其药物的不良反应逐渐增多,并影响患者的生活质量。中国医师协会肿瘤医师分会乳腺癌学组和中国抗癌协会国际医疗交流分会组织相关专家,基于循证医学证据,聚焦晚期恶性肿瘤骨转移的治疗,探讨骨改良药物不良反应的管理并形成共识。共识在我国2021年版的《骨改良药物安全性管理专家共识》基础上增加了骨改良药物相关颌骨坏死的定义,补充了更多骨改良药物不良反应的文献报道,总结了近年临床医师在实践中对不良反应处理的诊疗经验,最终经过专家组成员深入探讨提出合理建议,以指导临床医师对骨改良药物的安全性管理。

关键词：恶性肿瘤骨转移骨改良药物不良反应专家共识

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中国晚期三阴性乳腺癌临床诊疗指南(2024版)

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中华肿瘤杂志 2024年第6期46卷 471-480页

作者：中国抗癌协会乳腺癌专业委员会中国抗癌协会国际医疗交流分会中国医师协会肿瘤医师分会乳腺癌学组袁芃徐兵河岳健不详国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院特需医疗部北京100021 国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院药物临床试验研究中心北京100021

乳腺癌是全球女性最常见的恶性肿瘤,2020年GLOBOCAN流行病学数据显示,乳腺癌首次超过肺癌成为全球第一高发的恶性肿瘤,严重威胁女性健康。相较于欧美人群,中国女性患者的乳腺癌发病率相对较低,但是随着近年来生活方式、饮食习惯的改变等... 详细信息

乳腺癌是全球女性最常见的恶性肿瘤,2020年GLOBOCAN流行病学数据显示,乳腺癌首次超过肺癌成为全球第一高发的恶性肿瘤,严重威胁女性健康。相较于欧美人群,中国女性患者的乳腺癌发病率相对较低,但是随着近年来生活方式、饮食习惯的改变等,中国人群乳腺癌发病逐年增加。中国2020年年龄标化的乳腺癌发病率达到39.1/10万,新发乳腺癌达41.6万例,占全球每年新发乳腺癌总人数的18.4%。乳腺癌防治工作也日益严峻,其中,三阴性乳腺癌作为一种恶性程度高、预后较差的乳腺癌亚型,由于以往缺乏明确的治疗靶点,近年来治疗进展缓慢。尤其是晚期三阴性乳腺癌的治疗,由于治疗手段相对有限,有待进一步优化治疗建议。因此,在中国抗癌协会乳腺癌专业委员会、中国抗癌协会国际医疗交流分会和中国医师协会肿瘤医师分会乳腺癌学组的倡导下,中国乳腺癌各学科诊疗专家组结合国内外最新研究证据、治疗理念和经验,制定了中国晚期三阴性乳腺癌临床诊疗指南(2024版),旨在优化中国晚期三阴性乳腺癌精准治疗决策。

关键词：乳腺肿瘤晚期三阴性乳腺癌诊断治疗指南

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