Hyperprogressive disease in non-small cell lung cancer after PD-1/PD-L1 inhibitors immunotherapy: underlying killer
Yanping Li1, Tianhong Chen2, Tian Yi Nie1
1Department of Respiratory Medicine, The Third People's Hospital of Honghe Prefecture, Gejiu, China.
Abstract:
Immune checkpoint inhibitors (ICIs) target the negative regulatory pathway of T cells and effectively reactive the anti-tumor immune function of T cells by blocking the key pathway of the immune escape mechanism of the tumor-PD-1/PD-L1, and fundamentally changing the prospect of immunotherapy for non-small cell lung cancer patients. However, such promising immunotherapy is overshadowed by Hyperprogressive Disease, a response pattern associated with unwanted accelerated tumor growth and characterized by poor prognosis in a fraction of treated patients. This review comprehensively provides an overview of Hyperprogressive Disease in immune checkpoint inhibitor-based immunotherapy for non-small cell lung cancer including its definition, biomarkers, mechanisms, and treatment. A better understanding of the black side of immune checkpoint inhibitors therapy will provide a more profound insight into the pros and cons of immunotherapy.
Insights
Immune checkpoint inhibitors (ICIs) show promise for non-small cell lung cancer, but can cause Hyperprogressive Disease (HPD), an aggressive tumor growth. This review explores HPD
Area of Science:
- Oncology
- Immunology
- Medical Research
Background:
- Immune checkpoint inhibitors (ICIs) harness T-cell immune function against tumors by blocking PD-1/PD-L1 pathways.
- ICIs have transformed immunotherapy for non-small cell lung cancer (NSCLC).
- However, a subset of patients experiences Hyperprogressive Disease (HPD), characterized by accelerated tumor growth and poor prognosis.
Purpose of the Study:
- To provide a comprehensive overview of Hyperprogressive Disease (HPD) in the context of ICI therapy for NSCLC.
- To elucidate the definition, potential biomarkers, underlying mechanisms, and treatment strategies for HPD.
- To offer a balanced perspective on the benefits and risks of ICI therapy.
Main Methods:
- Literature review and synthesis of existing research on ICI therapy and HPD in NSCLC.
- Analysis of clinical data and preclinical studies related to HPD.
- Discussion of proposed mechanisms and therapeutic interventions.
Main Results:
- HPD represents a significant challenge in ICI therapy for NSCLC, despite its overall efficacy.
- Understanding HPD's characteristics, biomarkers, and mechanisms is crucial for patient management.
- Current treatment strategies for HPD are still under investigation.
Conclusions:
- ICI therapy offers significant benefits for NSCLC patients but carries the risk of HPD.
- Further research into HPD biomarkers and effective treatments is essential to optimize immunotherapy outcomes.
- A thorough understanding of HPD is vital for balancing the advantages and disadvantages of ICIs.
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