AccScience Publishing / EJMO / Volume 6 / Issue 1 / DOI: 10.14744/ejmo.2022.78280
RESEARCH ARTICLE

Differences between Hyperprogressive Disease and Progressive Disease in Patients Receiving Immunotherapy

Hasan Cagri Yildirim1 Deniz Can Guven1 Oktay Halit Aktepe1 Hakan Taban1 Feride Yilmaz1 Serkan Yasar1 Burak Yasin Aktas1 Gurkan Guner1 Omer Dizdar1 Sercan Aksoy1 Mustafa Erman1 Suayib Yalcin1 Saadettin Kilickap2
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1 Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
2 Department of Medical Oncology, Istinye University Faculty of Medicine, Istanbul, Turkey
Submitted: 2 January 2022 | Accepted: 5 March 2022 | Published: 9 March 2022
© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Objectives: Although immune checkpoint inhibitors (ICIs) became a vital part of cancer care, many patients do not respond to treatment. In this group, a few of the patients with a hyperprogressive disease (HPD) have shorter overall survival (OS) compared with those having a progressive disease (PD). Therefore, biomarkers are needed to differentiate HPD and PD.

Methods: Ninety-five patients treated with ICIs with progression according to response evaluation criteria ın solid tumors criteria in the first control imaging were included. HPD was defined according to Russo's work. The PILE scoring system, which includes pan-immune-inflammation value, lactate dehydrogenase, and Eastern Cooperative Oncology Group PS, was followed. The relationship between PILE score and HPD was analyzed.

Results: The median OS of all cohorts was 11.18 months. The patients in the HPD group had decreased OS (4.77 vs. 13.94 months, p<0.001) and progression-free survival (PFS) (1.89 vs. 3.16 months, p<0.001) compared with those in the PD group. The risk of HPD was higher than the risk of PD in patients with a high PILE score (p=0.001).

Conclusion: In this study, we showed that patients treated with ICI with a higher PILE score are at greater risk for HPD. The PILE score may be a biomarker to differentiate HPD from PD.

Keywords
Hyperprogressive disease
immun checkpoint inhibitors
immunotherapy
PILE score
Conflict of interest
None declared.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing