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Hyperprogression after immunotherapy
INTRODUCTION: Checkpoint inhibitors demonstrate very good anticancer effects, and some patients are long-time responders. As our experience to use these drugs increases, we see more and more patients having different kind of side effects which are usually not seen with chemotherapy. We have observed...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852633/ https://www.ncbi.nlm.nih.gov/pubmed/31807489 http://dx.doi.org/10.4103/sajc.sajc_389_18 |
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author | Abbas, Waseem Rao, Ranga Raju Popli, Swati |
author_facet | Abbas, Waseem Rao, Ranga Raju Popli, Swati |
author_sort | Abbas, Waseem |
collection | PubMed |
description | INTRODUCTION: Checkpoint inhibitors demonstrate very good anticancer effects, and some patients are long-time responders. As our experience to use these drugs increases, we see more and more patients having different kind of side effects which are usually not seen with chemotherapy. We have observed a subset of patients who appear to be “hyper-progressors,” with a greatly accelerated rate of tumor growth and clinical deterioration compared to pretherapy, which was also recently reported by Institut Gustave Roussy. MATERIALS AND METHODS: Medical records from all patients (N = 50) prospectively treated in our hospital by anti-PD-1/PD-L1 were analyzed. The tumor growth rate (TGR) prior (“REFERENCE;” REF) and upon (“EXPERIMENTAL”; EXP) anti-PD-1/PD-L1 therapy was compared to identify patients with accelerated tumor growth. Associations between TGR and overall survival (OS) were computed. RESULTS: Hyperprogressive disease (HPD) was defined as a RECIST progression at the first evaluation and as a ≥2-fold increase of the TGR between the REF and the EXP periods. Of 50 evaluable patients, four patients (8%) were considered as having HPD. At progression, patients with HPD had a higher rate of new lesions. HPD was associated with a worse outcome (OS). CONCLUSION: Hyperprogression was seen in 4 of 50 (8%) of patients, three of which had urothelial cancer and one malignant melanoma, treated with anti-PD-1 or anti-PD-L1 monotherapy. Patients, on immunotherapy, qualifying for hyperprogression had shorted OS. It is important to have a better understanding of hyperprogression on immunotherapy which shall be addressed in the ongoing immunotherapy studies. |
format | Online Article Text |
id | pubmed-6852633 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-68526332019-12-05 Hyperprogression after immunotherapy Abbas, Waseem Rao, Ranga Raju Popli, Swati South Asian J Cancer ORIGINAL ARTICLE: Immuno Oncology INTRODUCTION: Checkpoint inhibitors demonstrate very good anticancer effects, and some patients are long-time responders. As our experience to use these drugs increases, we see more and more patients having different kind of side effects which are usually not seen with chemotherapy. We have observed a subset of patients who appear to be “hyper-progressors,” with a greatly accelerated rate of tumor growth and clinical deterioration compared to pretherapy, which was also recently reported by Institut Gustave Roussy. MATERIALS AND METHODS: Medical records from all patients (N = 50) prospectively treated in our hospital by anti-PD-1/PD-L1 were analyzed. The tumor growth rate (TGR) prior (“REFERENCE;” REF) and upon (“EXPERIMENTAL”; EXP) anti-PD-1/PD-L1 therapy was compared to identify patients with accelerated tumor growth. Associations between TGR and overall survival (OS) were computed. RESULTS: Hyperprogressive disease (HPD) was defined as a RECIST progression at the first evaluation and as a ≥2-fold increase of the TGR between the REF and the EXP periods. Of 50 evaluable patients, four patients (8%) were considered as having HPD. At progression, patients with HPD had a higher rate of new lesions. HPD was associated with a worse outcome (OS). CONCLUSION: Hyperprogression was seen in 4 of 50 (8%) of patients, three of which had urothelial cancer and one malignant melanoma, treated with anti-PD-1 or anti-PD-L1 monotherapy. Patients, on immunotherapy, qualifying for hyperprogression had shorted OS. It is important to have a better understanding of hyperprogression on immunotherapy which shall be addressed in the ongoing immunotherapy studies. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6852633/ /pubmed/31807489 http://dx.doi.org/10.4103/sajc.sajc_389_18 Text en Copyright: © 2019 The South Asian Journal of Cancer http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | ORIGINAL ARTICLE: Immuno Oncology Abbas, Waseem Rao, Ranga Raju Popli, Swati Hyperprogression after immunotherapy |
title | Hyperprogression after immunotherapy |
title_full | Hyperprogression after immunotherapy |
title_fullStr | Hyperprogression after immunotherapy |
title_full_unstemmed | Hyperprogression after immunotherapy |
title_short | Hyperprogression after immunotherapy |
title_sort | hyperprogression after immunotherapy |
topic | ORIGINAL ARTICLE: Immuno Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852633/ https://www.ncbi.nlm.nih.gov/pubmed/31807489 http://dx.doi.org/10.4103/sajc.sajc_389_18 |
work_keys_str_mv | AT abbaswaseem hyperprogressionafterimmunotherapy AT raorangaraju hyperprogressionafterimmunotherapy AT popliswati hyperprogressionafterimmunotherapy |