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BMC Cancer
Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | Checkpoint Inhibitors | Research article

Hyperprogression after immunotherapy in patients with malignant tumors of digestive system

Authors: Zhi Ji, Zhi Peng, Jifang Gong, Xiaotian Zhang, Jian Li, Ming Lu, Zhihao Lu, Lin Shen

Published in: BMC Cancer | Issue 1/2019

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Abstract

Background

Immune checkpoint inhibitors (ICIs) were approved to have a significant antitumor activity in various tumor types. In practice, some patients do not seem to benefit from ICIs but rather to have accelerating disease. The aim of this study was to evaluate hyperprogression in patients with malignant tumors of digestive system treated with ICIs.

Methods

Medical records from consecutive patients with malignant tumors of digestive system treated with ICIs in Peking University Cancer Hospital were retrospectively collected. Tumor growth kinetics (TGK) on immunotherapy and TGK pre-immunotherapy were collected and TGK ratio (TGKR) was calculated. Hyperprogression was defined as TGKR≥2.

Results

From August 2016 to May 2017, 25 evaluable patients were identified from 45 patients with malignant tumors of digestive system. Five patients were considered as having hyperprogression. Three of 5 were neuroendocrine carcinomas (NECs) and the other 2 were adenocarcinomas. Four of 5 were treated with programmed cell death ligand 1 (PD-L1) inhibitor, the other one was treated with PD-L1 inhibitor combined with cytotoxic T lymphocyte associated antigen-4 (CTLA-4) inhibitor. Pseudoprogression was observed in 2 patients.

Conclusions

Hyperprogression was observed in a fraction of patients with malignant tumors of digestive system treated with ICIs. Further investigation is urgently needed.
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Metadata
Title
Hyperprogression after immunotherapy in patients with malignant tumors of digestive system
Authors
Zhi Ji
Zhi Peng
Jifang Gong
Xiaotian Zhang
Jian Li
Ming Lu
Zhihao Lu
Lin Shen
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5921-9

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