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High Throughput Sequential ELISA for Validation of Biomarkers of Acute Graft-Versus-Host Disease

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Blood Based Biomarkers as Predictive Factors for Hyperprogressive Disease.

Hasan Cagri Yildirim¹, Deniz Can Guven¹, Oktay Halit Aktepe¹

¹Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey.

Journal of Clinical Medicine

|September 9, 2022

Summary

Immunotherapy can lead to hyperprogressive disease (HPD), a condition associated with shorter survival. High lactate dehydrogenase (LDH) levels, low albumin, and an elevated neutrophil-to-lymphocyte ratio (NLR) predict increased HPD risk in cancer patients.

Keywords:

HPD NLR hyperprogression hypoalbuminemia immunotherapy

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Area of Science:

Oncology
Immunotherapy
Cancer Biomarkers

Background:

Immunotherapy has revolutionized cancer treatment, but can cause unexpected responses like hyperprogressive disease (HPD).
Hyperprogressive disease (HPD) is linked to poorer patient survival compared to non-HPD progression.
Identifying predictive factors for HPD is crucial for optimizing immunotherapy strategies.

Purpose of the Study:

To investigate factors associated with hyperprogressive disease (HPD) in patients receiving immunotherapy.
To identify potential biomarkers that predict HPD development during cancer immunotherapy.

Main Methods:

Retrospective analysis of 121 adult metastatic cancer patients treated with immunotherapy.
Collected baseline data including demographics, ECOG performance status, tumor type, and blood counts.
Utilized univariate and multivariate analyses to evaluate potential HPD predictors.

Main Results:

Hyperprogressive disease (HPD) was observed in 16.5% of patients.
Elevated lactate dehydrogenase (LDH) levels (p=0.001) were significantly associated with HPD.
Hypoalbuminemia (p=0.016) and a neutrophil-to-lymphocyte ratio (NLR) greater than 5 (p=0.007) were also linked to increased HPD risk.

Conclusions:

Hyperprogressive disease (HPD) occurs in a notable proportion of immunotherapy-treated patients.
High LDH, hypoalbuminemia, and elevated NLR are significant predictors of HPD.
These findings may aid in identifying patients at higher risk for HPD during immunotherapy.