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Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer

The occurrence of markedly accelerated tumor growth during immunotherapy is considered a new mode of progression called hyperprogressive disease (HPD) and its impact on pancreatic cancer (PC) patients receiving immunotherapy is unknown. In this study, we described and explored the incidence, prognos...

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Autores principales: Chen, Shiyun, Han, Lu, Guo, Shiyuan, Tan, Zhaoli, Dai, Guanghai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10486295/
https://www.ncbi.nlm.nih.gov/pubmed/37675466
http://dx.doi.org/10.1080/21645515.2023.2252692
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author Chen, Shiyun
Han, Lu
Guo, Shiyuan
Tan, Zhaoli
Dai, Guanghai
author_facet Chen, Shiyun
Han, Lu
Guo, Shiyuan
Tan, Zhaoli
Dai, Guanghai
author_sort Chen, Shiyun
collection PubMed
description The occurrence of markedly accelerated tumor growth during immunotherapy is considered a new mode of progression called hyperprogressive disease (HPD) and its impact on pancreatic cancer (PC) patients receiving immunotherapy is unknown. In this study, we described and explored the incidence, prognosis and predictors of HPD in patients with advanced PC treated with programmed cell death-1 (PD-1) inhibitors. We retrospectively analyzed clinicopathological data from 104 patients with advanced pancreatic cancer who were treated with PD-1 inhibitors at our institution during 2015–2020 and identified 10 (9.6%) patients with HPD. Overall survival (OS) was significantly poorer in patients with HPD compared to patients with progressive disease (PD) (median OS: 5.6 vs. 3.6 months, p < .01). Clinicopathological factors associated with the occurrence of HPD included smoking, metastatic sites >2, liver metastasis, antibiotic therapy within 21 days before immunotherapy (Abx B21), hemoglobin (Hb) level <110 g/L, and PD-1 inhibitor treatment line >2. Subgroup analysis showed that high levels of CA19-9 at baseline were associated with the development of subsequent HPD (p = .024) and a worse prognosis (mOS:16.2 months vs. 6.1 months, p < .01). Our study demonstrated that HPD may occur in PC patients treated with PD-1 inhibitors and is associated with several clinicopathological characteristics and poor prognosis. The baseline tumor marker CA19-9 may be one of the early predictors of HPD development in PC patients receiving immunotherapy.
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spelling pubmed-104862952023-09-09 Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer Chen, Shiyun Han, Lu Guo, Shiyuan Tan, Zhaoli Dai, Guanghai Hum Vaccin Immunother Immunotherapy - Cancer The occurrence of markedly accelerated tumor growth during immunotherapy is considered a new mode of progression called hyperprogressive disease (HPD) and its impact on pancreatic cancer (PC) patients receiving immunotherapy is unknown. In this study, we described and explored the incidence, prognosis and predictors of HPD in patients with advanced PC treated with programmed cell death-1 (PD-1) inhibitors. We retrospectively analyzed clinicopathological data from 104 patients with advanced pancreatic cancer who were treated with PD-1 inhibitors at our institution during 2015–2020 and identified 10 (9.6%) patients with HPD. Overall survival (OS) was significantly poorer in patients with HPD compared to patients with progressive disease (PD) (median OS: 5.6 vs. 3.6 months, p < .01). Clinicopathological factors associated with the occurrence of HPD included smoking, metastatic sites >2, liver metastasis, antibiotic therapy within 21 days before immunotherapy (Abx B21), hemoglobin (Hb) level <110 g/L, and PD-1 inhibitor treatment line >2. Subgroup analysis showed that high levels of CA19-9 at baseline were associated with the development of subsequent HPD (p = .024) and a worse prognosis (mOS:16.2 months vs. 6.1 months, p < .01). Our study demonstrated that HPD may occur in PC patients treated with PD-1 inhibitors and is associated with several clinicopathological characteristics and poor prognosis. The baseline tumor marker CA19-9 may be one of the early predictors of HPD development in PC patients receiving immunotherapy. Taylor & Francis 2023-09-07 /pmc/articles/PMC10486295/ /pubmed/37675466 http://dx.doi.org/10.1080/21645515.2023.2252692 Text en © 2023 The Author(s). Published with license by Taylor & Francis Group, LLC. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
spellingShingle Immunotherapy - Cancer
Chen, Shiyun
Han, Lu
Guo, Shiyuan
Tan, Zhaoli
Dai, Guanghai
Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer
title Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer
title_full Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer
title_fullStr Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer
title_full_unstemmed Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer
title_short Hyperprogressive disease during PD-1 blockade in patients with advanced pancreatic cancer
title_sort hyperprogressive disease during pd-1 blockade in patients with advanced pancreatic cancer
topic Immunotherapy - Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10486295/
https://www.ncbi.nlm.nih.gov/pubmed/37675466
http://dx.doi.org/10.1080/21645515.2023.2252692
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