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CTCAE GRADING

What is CTCAE grading?

CTCAE grading assigns an adverse event a severity grade from 1 to 5 using the Common Terminology Criteria for Adverse Events, published by the US National Cancer Institute (NCI). Each event is matched to a CTCAE term, such as Fatigue or Neutrophil count decreased, and graded against that term's own criteria. The general scale: Grade 1 mild, intervention not indicated; Grade 2 moderate, minimal, local or noninvasive intervention indicated, or limiting instrumental activities of daily living (ADL); Grade 3 severe or medically significant, hospitalization indicated, or limiting self-care ADL; Grade 4 life-threatening, urgent intervention indicated; Grade 5 death related to the adverse event. Not every grade exists for every term. CTCAE v5.0 (2017) has 837 terms and v6.0 (July 2025) has 850, and cut-offs moved for terms such as Neutrophil count decreased. Look up any term in both versions at ctcae.ai/terms; the grades are explained at ctcae.ai/blog/ctcae-grades-1-to-5-explained.

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