Psuedoprogression mimicking hyperprogressive disease after pembrolizumab treatment in a patient with lung cancer

Hashimoto, Kosuke; Kaira, Kyoichi; Kawasaki, Tomonori; Yamaguchi, Ou; Kagamu, Hiroshi

doi:10.1016/j.lungcan.2019.11.019

Cited by 2 publications

(2 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present patient showed clinically defined HPD following the application of pembrolizumab, with a time-to-treatment of less than 2 months, a 55% increase in tumor burden, and a 2.3-fold increase in the TGKR, which is completely in line with the clinical definition of HPD by Kato (11). Although pseudoprogression can sometimes be associated with radiological findings of accelerated tumor growth and is similar in appearance to HPD (15), pseudoprogression should not be considered when a patient's symptoms continuously worsen. The patient also had some obvious positive symptoms and signs, including moderate fatigue, loss of appetite, abdominal pain, and abdominal tenderness.…”

Section: Discussionsupporting

confidence: 86%

Excellent Response to Atezolizumab After Clinically Defined Hyperprogression Upon Previous Treatment With Pembrolizumab in Metastatic Triple-Negative Breast Cancer: A Case Report and Review of the Literature

et al. 2021

View full text Add to dashboard Cite

Immunotherapy with immune checkpoint inhibitors (ICIs), including programmed cell death protein-1 (PD-1) and programmed cell death ligand-1 (PD-L1) inhibitors, has revolutionized the systematic treatment of advanced and metastatic solid tumors. However, the response rate to ICIs is unsatisfactory, and unexpected hyperprogressive disease (HPD) is even observed in a small subgroup of patients. Patients with HPD usually have worsening clinical symptoms and poorer survival, and therapeutic strategies are extremely limited. Here, we presented a patient with HPD who had used a PD-L1 inhibitor and was highly responsive to the sequential use of a PD-1 inhibitor. A 67-year-old woman with metastatic triple-negative breast cancer was treated with pembrolizumab plus chemotherapy after progression on previous multiple-line chemotherapy treatments. After 2 cycles of treatments, she rapidly developed HPD, as confirmed by radiological evaluation and worsening symptoms. At that time, pembrolizumab was discontinued, and she switched to the PD-L1 inhibitor atezolizumab plus chemotherapy. This patient partially responded to atezolizumab plus chemotherapy without experiencing severe drug-related adverse effects. This is the first reported case of metastatic breast cancer in a patient with radiologically confirmed HPD after pembrolizumab therapy in which successful rechallenge with atezolizumab relieved clinical symptoms. Further studies with larger sample sizes involving a deeper translational investigation of HPD are needed to confirm the efficacy and mechanism of sequential application of different ICIs for the clinical management of HPD.

show abstract

Section: Discussionsupporting

confidence: 86%

Excellent Response to Atezolizumab After Clinically Defined Hyperprogression Upon Previous Treatment With Pembrolizumab in Metastatic Triple-Negative Breast Cancer: A Case Report and Review of the Literature

et al. 2021

View full text Add to dashboard Cite

show abstract

“…However, definitions based on radiological assessment alone have substantial technical limitations. The possibility of pseudoprogression (PsPD) exists when progressive deterioration of pulmonary infiltrative shadows is observed within 4 weeks among advanced NSCLC patients after the initial administration of anti-PD-1 antibody ( 22 ). Current clinical and radiological assessment strategies are inadequate to distinguish PsPD with HPD.…”

Section: Differentiating Hpd From Pseudoprogressionmentioning

confidence: 99%

Hyperprogressive disease in non-small cell lung cancer after PD-1/PD-L1 inhibitors immunotherapy: underlying killer

Li¹,

Chen²,

Nie³

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

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.

show abstract

Psuedoprogression mimicking hyperprogressive disease after pembrolizumab treatment in a patient with lung cancer

Cited by 2 publications

References 3 publications

Excellent Response to Atezolizumab After Clinically Defined Hyperprogression Upon Previous Treatment With Pembrolizumab in Metastatic Triple-Negative Breast Cancer: A Case Report and Review of the Literature

Excellent Response to Atezolizumab After Clinically Defined Hyperprogression Upon Previous Treatment With Pembrolizumab in Metastatic Triple-Negative Breast Cancer: A Case Report and Review of the Literature

Hyperprogressive disease in non-small cell lung cancer after PD-1/PD-L1 inhibitors immunotherapy: underlying killer

Contact Info

Product

Resources

About