Hyperprogression and Immunotherapy: Fact, Fiction, or Alternative Fact?

Jacob J. Adashek, Ishwaria M. Subbiah, Ignacio Matos, Elena Garralda, Arjun K. Menta, Dhakshina Moorthy Ganeshan, Vivek Subbiah

Research output: Contribution to journalReview articlepeer-review

75 Scopus citations

Abstract

Immunotherapy (IO) has altered the therapeutic landscape for multiple cancers. There are emerging data from retrospective studies on a subset of patients who do not benefit from IO, instead experiencing rapid progression with dramatic acceleration of disease trajectory, termed ‘hyperprogressive disease’ (HPD). The incidence of HPD ranges from 4% to 29% from the studies reported. Biological basis and mechanisms of HPD are currently being elucidated, with one theory involving the Fc region of antibodies. Another group has shown EGFR and MDM2/MDM4 amplifications in patients with HPD. This phenomenon has polarized oncologists who debate that this could still reflect the natural history of the disease. Thus, prospective studies are urgently needed to confirm the underlying biology, predict patients who are susceptible to HPD, and determine the modality of therapy post progression.

Original languageEnglish (US)
Pages (from-to)181-191
Number of pages11
JournalTrends in Cancer
Volume6
Issue number3
DOIs
StatePublished - Mar 2020

Keywords

  • cancer clinical trials
  • hyperprogressive disease
  • immune checkpoint inhibitors
  • immunotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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