JTO Clinical and Research Reports (Jan 2021)

Comparison of Different Methods for Defining Hyperprogressive Disease in NSCLC

  • Pedro Rocha, MD,
  • Didac Ramal, MD,
  • Enric Ripoll, MD,
  • Laura Moliner, MD,
  • Alex Corbera, MD,
  • Max Hardy-Werbin, MD, PhD,
  • Mayra Orrillo, MD,
  • Álvaro Taus, MD,
  • Flavio Zuccarino, MD,
  • Joan Gibert,
  • Júlia Perera-Bel,
  • David Casadevall, MD, PhD,
  • Edurne Arriola, MD, PhD

Journal volume & issue
Vol. 2, no. 1
p. 100115

Abstract

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Introduction: Hyperprogressive disease (HPD) as a consequence of immune checkpoint inhibitors in NSCLC has been reported in multiple studies. However, inconsistent results in incidence and survival outcomes within studies, together with different assessment methods, have led to increasing controversy regarding the concept of HPD. Methods: Consecutive patients treated with nivolumab (N = 42) or docetaxel (N = 37) were evaluated. HPD was quantified by applying three different methods (tumor growth rate [TGR], tumor growth kinetics [TGK], and Response Evaluation Criteria in Solid Tumors version 1.1 [RECIST 1.1]). HPD rates were compared between and within both cohorts using the different methods. Results: Using TGR, TGK, and RECIST 1.1, we identified seven (16.7%), seven (16.7%), and six (14.3%) patients with HPD in the nivolumab cohort and three (8.1%), four (10.8%), and five (13.6%) in the docetaxel cohort, respectively. We observed a higher concordance between TGR and TGK (90.1%) compared with RECIST 1.1 (31.3% and 37.5% with TGR and TGK, respectively). We found no significant differences in the overall survival between patients with progressive disease and HPD in either cohort. Conclusions: TGR and TGK revealed high concordance rates for identifying patients with HPD in NSCLC. The incidence of HPD was numerically higher in patients treated with immune checkpoint inhibitors. Standardization of methods for measuring HPD and its exploration in larger studies are needed to establish its clinical meaning in NSCLC.

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