Patterns of Response and Progression to Immunotherapy

Area of Science:

• Oncology
• Immunology
• Clinical Trials

Background:

• Immunotherapy response patterns can differ from traditional treatments like chemotherapy.
• Pseudoprogression, a delayed response after initial progression, has been observed but is rare (less than 10%).
• Hyperprogression, rapid progression after immunotherapy, affects 9-29% of patients, with its detrimental effect yet to be confirmed.

Purpose of the Study:

• To analyze response and progression patterns in cancer patients treated with immunotherapy.
• To evaluate the utility of immune-related response criteria versus classic RECIST for immunotherapy assessment.
• To highlight the need for predictive biomarkers for immunotherapy efficacy and progression.

Main Methods:

• Review of existing literature on immunotherapy response and progression patterns.
• Comparison of immune-specific criteria (irRC, irRECIST, iRECIST) with classic RECIST.
• Analysis of reported rates of pseudoprogression and hyperprogression.

Main Results:

• Pseudoprogression is rare across tumor types (<10%).
• Hyperprogression rates range from 9% to 29%, with its detrimental effect requiring further investigation.
• Classic RECIST remains a rational method for assessing immunotherapy response due to the rarity of pseudoprogression and the uncertainty surrounding hyperprogression.

Conclusions:

• Classic RECIST is a suitable method for assessing immunotherapy response.
• Continuation of immunotherapy beyond progression should be limited to carefully selected patients.
• Identifying predictive biomarkers for immunotherapy efficacy and hyperprogression is crucial.