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Hyperprogression after immunotherapy.

Waseem Abbas1, Ranga Raju Rao1, Swati Popli1

  • 1Department of Medical Oncology, MAX Institute of Cancer Care, Shalimarbagh, Delhi, India.

South Asian Journal of Cancer
|December 7, 2019
PubMed
Summary
This summary is machine-generated.

Checkpoint inhibitors can cause hyperprogressive disease (HPD), an accelerated tumor growth, in 8% of patients. This HPD phenomenon is linked to worse overall survival outcomes in cancer patients.

Keywords:
Hyperprogression after immunotehrapyhyperprogression with check point inhibitorsimmunotherapy linked to hyperprogression

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Area of Science:

  • Oncology
  • Immunotherapy
  • Cancer Research

Background:

  • Checkpoint inhibitors (anti-PD-1/PD-L1) show significant anticancer effects.
  • An emerging side effect is hyperprogressive disease (HPD), characterized by accelerated tumor growth.
  • HPD presents a clinical challenge distinct from traditional chemotherapy side effects.

Purpose of the Study:

  • To identify and characterize hyperprogressive disease (HPD) in patients treated with anti-PD-1/PD-L1 therapy.
  • To compare tumor growth rates before and during immunotherapy.
  • To assess the association between HPD and overall survival (OS).

Main Methods:

  • Retrospective analysis of medical records from 50 patients treated with anti-PD-1/PD-L1.
  • Calculation of tumor growth rate (TGR) during reference (REF) and experimental (EXP) periods.
  • Definition of HPD as RECIST progression and a ≥2-fold increase in TGR.

Main Results:

  • Hyperprogressive disease (HPD) was identified in 4 out of 50 (8%) evaluable patients.
  • Patients with HPD exhibited a higher incidence of new lesions upon progression.
  • HPD was significantly associated with poorer overall survival (OS).

Conclusions:

  • Hyperprogression occurred in 8% of patients, predominantly in urothelial cancer and malignant melanoma.
  • Patients experiencing HPD on immunotherapy had a markedly reduced overall survival.
  • Further research is crucial to understand and manage HPD in immunotherapy settings.