Pseudoprogression and hyperprogression after checkpoint blockade

Area of Science:

• Oncology
• Immunotherapy

Background:

• Immune checkpoint inhibitors (ICIs) offer significant clinical benefits for various cancers.
• Patient responses to ICIs are heterogeneous, including pseudoprogression and hyperprogression.
• Hyperprogression is a rare but rapid tumor progression after immunotherapy, posing a clinical challenge.

Purpose of the Study:

• To review existing research on hyperprogression following immune checkpoint blockade.
• To highlight the unknown aspects of hyperprogression, including its incidence, basis, and predictive biomarkers.
• To identify areas requiring further investigation in hyperprogression.

Main Methods:

• Literature review of studies on immune checkpoint inhibitors and tumor response.
• Analysis of clinical data and research findings related to pseudoprogression and hyperprogression.
• Synthesis of current knowledge on the mechanisms and identification of hyperprogression.

Main Results:

• Pseudoprogression is increasingly understood, but hyperprogression remains largely uncharacterized.
• The incidence, underlying mechanisms, and predictive biomarkers for hyperprogression are largely unknown.
• Immune checkpoint blockade may detrimentally affect a small subset of patients, leading to hyperprogression.

Conclusions:

• Accurate evaluation of ICI efficacy is crucial to avoid premature treatment withdrawal or prolonged ineffective therapy.
• Further research is urgently needed to elucidate the incidence, basis, and identification of hyperprogression.
• Understanding hyperprogression is essential for optimizing immunotherapy strategies and patient outcomes.