Definitions, outcomes, and management of hyperprogression in patients with non-small-cell lung cancer treated with immune checkpoint inhibitors

Abbar, Baptiste; Castelbajac, Victoire de; Gougis, Paul; Assoun, Sandra; Pluvy, Johan; Tesmoingt, Chloé; Théou–Anton, Nathalie; Cazes, Aurélie; Namour, Céline; Khalil, Antoine; Gounant, V.; Besse, Benjamin; Zalcman, Gérard; Brosseau, S.

doi:10.1016/j.lungcan.2020.12.026

Cited by 14 publications

(37 citation statements)

References 42 publications

(85 reference statements)

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“…The overall survival (OS) of the HPD group using the new standard decreased significantly, which was statistically significant, compared to the non-HPD group, whereas the OS of the HPD group using TGR decreased, but not statistically significantly. However, Gomes da Morais et al [18] reviewed the literature and compared the main criteria of HPD proposed by Ferté, Le Tourneau, Garralda, and Caramella. These criteria include ΔTGR > 100 (Caramella) and 20% target lesion progression plus the occurrence of new lesions in at least two different organs.…”

Section: Diagnostic Criteria For Hpdmentioning

confidence: 99%

“…Later, Abbar et al . [ 19 ] expanded the study to 169 advanced NSCLC patients treated with ICI; the incidence of HPD (11.3%, 5.7%, 17.0%, 9.6% and 31.7%) was calculated based on five indicators. In addition to the discovery of large heterogeneity, the definition of HPD based on TTF standard was correlated with OS, while the other diagnostic criteria were not correlated with OS.…”

Section: Diagnostic Criteria For Hpdmentioning

confidence: 99%

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Mechanism underlying the immune checkpoint inhibitor-induced hyper-progressive state of cancer

Ding¹,

Wen²,

Tong³

et al. 2022

CDR

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Immune checkpoint inhibitors (ICIs) are gradually replacing chemotherapy as the cornerstone of the treatment of advanced malignant tumors because of their long-lasting and significant effect in different tumor types and greatly prolonging the survival time of patients. However, not all patients can respond to ICIs, and even rapid tumor growth after treatment with ICI has been observed in a number of clinical studies. This rapid progression phenomenon is called hyper-progressive disease (HPD). The occurrence of HPD is not uncommon. Past statistics show that the incidence of HPD is 4%-29% in different tumor types, and the progression-free survival and overall survival of patients with HPD are significantly shorter than those of the non-HPD progressor group. With the deepening of the study of HPD, we have established a preliminary understanding of HPD, but the diagnostic criteria of HPD are still not unified, and the addition of biomarkers may break this dilemma. In addition, quite a few immune cells have been found to be involved in the occurrence and development of HPD in the tumor microenvironment, indicating that the molecular mechanism of HPD may be triggered by a variety of ongoing events at the same time. In this review, we summarize past findings, including case reports, clinical trials, and fundamental research; compare the diagnostic criteria, incidence, and clinical prognostic indicators of HPD in different studies; and explore the molecular mechanism and future research direction of HPD.

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Section: Diagnostic Criteria For Hpdmentioning

confidence: 99%

Section: Diagnostic Criteria For Hpdmentioning

confidence: 99%

Mechanism underlying the immune checkpoint inhibitor-induced hyper-progressive state of cancer

Ding¹,

Wen²,

Tong³

et al. 2022

CDR

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show abstract

“…In addition to progress in the primary site, there was also significant progress in other sites, especially in the liver and bones 27,31 . Compared with patients without HPD, patients with more than 2 metastatic sites and higher values of primary lesion size before immune checkpoint inhibitor treatment are more likely to show HPD 25,31,32,36,56 . For example, the first detection of liver metastasis before treatment was related to HPD, so immune checkpoint inhibitors should be used with caution in these patients 29,36 .…”

Section: Clinical and Molecular Characteristics Of Hpdmentioning

confidence: 99%

“…22 Although HPD was found in 2016, its definition and diagnostic criteria have not been unified. It is worth noting that continuous studies have shown that HPD is associated with poor OS, 11,13,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] and may even accelerate death in bladder carcinoma and squamous cell carcinoma. 15,31 Moreover, a shorter period of PFS has a certain contribution to the prognosis and even death.…”

Section: Definition Of Hpdmentioning

confidence: 99%

“…27,31 Compared with patients without HPD, patients with more than 2 metastatic sites and higher values of primary lesion size before immune checkpoint inhibitor treatment are more likely to show HPD. 25,31,32,36,56 For example, the first detection of liver metastasis before treatment was related to HPD, so immune checkpoint inhibitors should be used with caution in these patients. 29,36 Also, HPD was significantly correlated with the presence of regional recurrence but not with the presence of local recurrence.…”

Section: Gene-related Biomarkersmentioning

confidence: 99%

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Current Understanding and Future Perspectives on Hyperprogressive Disease Highlight the Tumor Microenvironment

Zhong

et al. 2022

The Journal of Clinical Pharma

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Cancer immunotherapy with immune checkpoint inhibitors has revolutionized traditional cancer therapy. Although many patients have achieved long‐term survival benefits from treatment with immune checkpoint inhibitors, there are still some patients who develop rapid tumor progression after immunotherapy, known as HPD. Here, we summarize the current knowledge on HPD after treatment with immune checkpoint inhibitors to promote a more thorough understanding of the disease. This review focuses on multiple aspects of HPD, especially the tumor microenvironment, with the hope that more reliable biomarkers and therapeutics will be established for HPD in the future.

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Early mortality factors in immune checkpoint inhibitor monotherapy for advanced or metastatic non-small cell lung cancer

Takeuchi

Kondo

Okano

et al. 2022

J Cancer Res Clin Oncol

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Purpose Immune checkpoint inhibitors (ICI) are a promising treatment, but may cause hyperprogressive disease and early death. The present study investigated early mortality factors in ICI monotherapy for lung cancer. Patients and methods We retrospectively reviewed all patients diagnosed with advanced or metastatic non-small cell lung cancer (NSCLC) and treated with ICI monotherapy (nivolumab, pembrolizumab, and atezolizumab) between March 2016 and August 2021 at National Hospital Organization Kochi Hospital and Tokushima University. Early death was defined as patients who died within 60 days of ICI treatment. Results A total of 166 patients were included. The majority of patients (87%) had an Eastern cooperative oncology group (ECOG) Performance status (PS) of 0/1. There were 21 early deaths. Significant differences were observed in ECOG PS, the histological type, liver metastasis, tumor size, the white blood cell count, neutrophils (%), lymphocytes (%), the neutrophil-to-lymphocyte ratio in serum (sNLR), C-reactive protein (CRP), and albumin between the groups with or without early death. Univariate logistic regression analyses identified ECOG PS score ≥ 2, liver metastasis, tumor size ≥ 5 cm, neutrophils ≥ 69%, lymphocytes < 22%, sNLR ≥ 4, CRP ≥ 1 mg/dl, and albumin < 3.58 g/dl as significant risk factors for early death. A multivariate logistic regression analysis revealed that liver metastasis (Odds ratio [OR], 10.3; p = 0.008), ECOG PS score ≥ 2 (OR, 8.0; p = 0.007), and a smoking history (OR, 0.1; p = 0.03) were significant risk factors for early death. Conclusion Liver metastases, ECOG PS score ≥ 2, and a non-smoking history are early mortality factors in ICI monotherapy for advanced or metastatic NSCLC.

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Definitions, outcomes, and management of hyperprogression in patients with non-small-cell lung cancer treated with immune checkpoint inhibitors

Cited by 14 publications

References 42 publications

Mechanism underlying the immune checkpoint inhibitor-induced hyper-progressive state of cancer

Mechanism underlying the immune checkpoint inhibitor-induced hyper-progressive state of cancer

Current Understanding and Future Perspectives on Hyperprogressive Disease Highlight the Tumor Microenvironment

Early mortality factors in immune checkpoint inhibitor monotherapy for advanced or metastatic non-small cell lung cancer

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