协和医学杂志2026，Vol.17Issue(1)：16-22,7.DOI:10.12290/xhyxzz.2025-1008
基于机体失调反应的肿瘤免疫治疗相关器官功能不全治疗方案
Treatment Strategies for Tumor Immunotherapy-Related Organ Dysfunction Based on Host Unregulated Response
摘要
Abstract
Cancer immunotherapy,particularly immune checkpoint inhibitors(ICIs),has significantly improved the prognosis of patients with various malignancies.However,the immune-related adverse events(irAEs)and associated organ dysfunction they trigger have become key issues affecting treatment safety and long-term patient survival.Pathophysiologically,irAEs share common features with classical critical illnesses like sepsis,both involving host/organ unregulated response(HOUR).The key distinction lies in irAEs primari-ly manifesting as overactivation of the immune system.Clinically,differentiating irAEs from infection in ICI-treated patients presenting with new-onset organ dysfunction is often challenging.Building upon the HOUR theoretical framework,this article proposes a PRISM management strategy integrating multi-omics technology,aiming to provide a personalized approach for the diagnosis and treatment of immunotherapy-related organ dysfunction.The PRISM strategy encompasses five key components:Precise etiological differentiation,Regula-tion of host response,Immunotherapy risk prediction,Support of organ function,and Multidisciplinary collabo-ration.By integrating multi-omics biomarkers and patient clinical characteristics,the PRISM strategy enables early warning and precise phenotyping of organ dysfunction and offers individualized intervention plans.It holds promise for significantly improving the clinical management of irAEs,enhancing patients'quality of life and long-term prognosis,thereby providing a theoretical foundation and practical guidance for the precise prevention and treatment of critical illnesses associated with immunotherapy.关键词
重症/免疫相关不良事件/机体失调反应/器官功能不全/多组学技术Key words
critical illness/immune-related adverse events/host unregulated response/organ dysfunction/multi-omics technology分类
医药卫生引用本文复制引用
巩师毅,王小亭..基于机体失调反应的肿瘤免疫治疗相关器官功能不全治疗方案[J].协和医学杂志,2026,17(1):16-22,7.基金项目
四大慢病重大专项(2024ZD0562100) Noncommunicable Chronic Diseases-National Science and Technology Major Project(2024ZD0562100) （2024ZD0562100）
