CTCAE (Common Terminology Criteria for Adverse Events) is the standardized oncology grading system used across chemotherapy, immunotherapy, radiation, and clinical trials to classify treatment-related toxicity severity from Grade 1 (mild) to Grade 5 (death).
[Official reference link](https://dctd.cancer.gov/research/ctep-trials/for-sites/adverse-events/ctcae-v5-5x7.pdf)
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| Grade | Meaning | Typical Action |
|---|---|---|
| 1 | Mild | Continue therapy |
| 2 | Moderate | Hold therapy ± steroids |
| 3 | Severe | High-dose steroids; admit |
| 4 | Life-threatening | Usually permanent discontinuation |
| 5 | Death | — |
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### HPB-Relevant immune related adverse events (irAE)
- Hepatitis
- Colitis
- Pancreatitis
- Cholangitis-like injury
- Endocrinopathies
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> [!tip]
> Immune toxicities are inflammatory syndromes, not classic cytotoxic chemotherapy side effects.
> [!warning]
> Avoid infliximab in severe immune-mediated hepatitis.