Refining criteria of hyperprogression (HPD) with immune checkpoint inhibitors (ICIs) to improve clinical applicability

García, Ignacio Hernández; García-Ruiz, Alonso; Martín-Liberal, Juan; Hierro, Cinta; Amat, Mora; Viaplana, Cristina; Mur, Gemma; Villar, M. Vieito; Braña, Irene; Azaro, Analía; Pérez, Carlos Martínez; Freixinós, V. Rodriguez; Argilés, Guillem; Oliveira, Mafalda; Font, E. Felip; Muñoz‐Couselo, Eva; Tabernero, Josep; Dienstmann, Rodrigo; Garralda, Elena

doi:10.1093/annonc/mdy303.011

Cited by 3 publications

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“…By definition, HPD diagnosis using TGR or TGK requires the presence of measurable target lesions and at least three sequential imaging (i.e., pre-treatment, baseline, and post/under-treatment), which may not be fully available. To overcome these caveats, clinical criteria such as time-to-treatment failure [11,14] and ECOG (Eastern Cooperative Oncology Group) performance status deterioration [14] or alternative radiologic criteria such as post-therapy increase of tumor burden [14,43] have been suggested. These criteria may be useful in clinical settings to diagnose HPD in patients that did not have prior imaging and patients who receive immune checkpoint inhibitor therapy as first-line therapy.…”

Section: Discussionmentioning

confidence: 99%

“…These criteria may be useful in clinical settings to diagnose HPD in patients that did not have prior imaging and patients who receive immune checkpoint inhibitor therapy as first-line therapy. However, these clinical criteria may not be fully accurate as they use fundamentally different definitions, and studies [17,43] have reported low concordance between the two types of definitions. As HPD is distinguished from normal progression by its acceleration of tumor growth upon the initiation of therapy, comparing the speed of progression before and after therapy is necessary to precisely identify HPD.…”

Section: Discussionmentioning

confidence: 99%

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Hyperprogressive Disease during Anti-PD-1 (PDCD1) / PD-L1 (CD274) Therapy: A Systematic Review and Meta-Analysis

Kim

Lee

Kang

et al. 2019

Cancers

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Hyperprogressive disease (HPD) is a recently acknowledged pattern of rapid tumor progression after the initiation of immune checkpoint inhibitors. HPD has been observed across various types of tumors and has been associated with poor survival. We performed a meta-analysis to identify baseline (i.e., prior to programmed cell death 1 [PD-1, PDCD1] / programmed cell death 1 ligand 1 [PD-L1, CD274] inhibitor therapy) patient factors associated with risks of developing HPD during PD-1/PD-L1 inhibitor therapy. We searched eight databases until 6 June 2019. We calculated the summary odds ratio (OR) and its 95% confidence interval (CI) using the random-effects model and explored between-study heterogeneity and small-study effects. A total of nine articles was eligible (217 HPD cases, 1519 cancer patients) for meta-analysis. There was no standard definition of HPD, and the incidence of HPD ranged from 1 to 30%. We identified twenty-three baseline patient factors, of which five factors were statistically significantly associated with HPD. These were serum lactate dehydrogenase (LDH) above the upper normal limit (OR = 1.89, 95% CI = 1.02–3.49, p = 0.043), more than two metastatic sites (OR = 1.86, 1.34–2.57, p < 0.001), liver metastases (OR = 3.33, 2.07–5.34, p < 0.001), Royal Marsden Hospital prognostic score of 2 or above (OR = 3.33, 1.96–5.66, p < 0.001), and positive PD-L1 expression status that was inversely correlated with HPD (OR = 0.60, 0.36–0.99, p = 0.044). Between-study heterogeneity was low. Evidence of small-study effect was found in one association (PD-L1 expression). Subset analyses of patients with non-small cell lung cancer showed similar results. Future studies are warranted to identify underlying molecular mechanisms and to test their roles as predictive biomarkers of HPD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hyperprogressive Disease during Anti-PD-1 (PDCD1) / PD-L1 (CD274) Therapy: A Systematic Review and Meta-Analysis

Kim

Lee

Kang

et al. 2019

Cancers

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Are we ready to describe response or progression to immunotherapy in lung cancer?

Guaitoli

Baldessari

Bertolini

et al. 2019

Critical Reviews in Oncology/Hematology

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Hyperprogression and Immune Checkpoint Inhibitors: Hype or Progress?

et al. 2019

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There are currently seven approved immune checkpoint inhibitors (ICIs) for the treatment of various cancers. These drugs are associated with profound, durable responses in a subset of patients with advanced cancers. Unfortunately, in addition to individuals whose tumors show resistance, there is a minority subgroup treated with ICIs who demonstrate a paradoxical acceleration in the rate of growth or their tumors-hyperprogressive disease. Hyperprogressive disease is associated with significantly worse outcomes in these patients. This phenomenon, though still a matter of dispute, has been recognized by multiple groups of investigators across the globe and in diverse types of cancers.Correspondence: Razelle Kurzrock, M.D.

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Refining criteria of hyperprogression (HPD) with immune checkpoint inhibitors (ICIs) to improve clinical applicability

Cited by 3 publications

References 0 publications

Hyperprogressive Disease during Anti-PD-1 (PDCD1) / PD-L1 (CD274) Therapy: A Systematic Review and Meta-Analysis

Hyperprogressive Disease during Anti-PD-1 (PDCD1) / PD-L1 (CD274) Therapy: A Systematic Review and Meta-Analysis

Are we ready to describe response or progression to immunotherapy in lung cancer?

Hyperprogression and Immune Checkpoint Inhibitors: Hype or Progress?

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