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Hyperprogressive disease and its clinical impact in patients with recurrent and/or metastatic head and neck squamous cell carcinoma treated with immune-checkpoint inhibitors: Korean cancer study group HN 18-12
- Title
- Hyperprogressive disease and its clinical impact in patients with recurrent and/or metastatic head and neck squamous cell carcinoma treated with immune-checkpoint inhibitors: Korean cancer study group HN 18-12
- Authors
- Park, Jihyun; Chun, Sang Hoon; Lee, Yun-Gyoo; Chang, Hyun; Lee, Keun-Wook; Kim, Hye Ryun; Shin, Seong Hoon; An, Ho Jung; Lee, Kyoung Eun; Hwang, In Gyu; Ahn, Myung-Ju; Kim, Sung-Bae; Keam, Bhumsuk
- Ewha Authors
- 이경은
- SCOPUS Author ID
- 이경은
- Issue Date
- 2020
- Journal Title
- JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
- ISSN
- 0171-5216
1432-1335
- Citation
- JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY vol. 146, no. 12, pp. 3359 - 3369
- Keywords
- Hyperprogressive disease; Immune-checkpoint inhibitors; Prognostic; Impact; Recurrent and; or metastatic; Head and neck squamous carcinoma
- Publisher
- SPRINGER
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Purpose Although immune-checkpoint inhibitors (ICIs) have emerged as therapeutic options for recurrent and/or metastatic head and neck squamous cell carcinoma (R/M-HNSCC), concerns have been raised on exceptional acceleration of tumor growth during treatment with ICIs, a condition described as hyperprogressive disease (HPD). This study examined the incidence, potential predictors, and clinical impact of HPD in R/M-HNSCC. Methods We retrospectively collected data of patients with R/M-HNSCC treated with ICIs between January 2013 and June 2018 from 11 medical centers in Korea. HPD was defined as tumor growth kinetics ratio (TGKr) > 2, which was calculated by comparing TGK on ICIs with that before treatment with ICIs. Results Of 125 patients, 68 (54.4%) obtained progressive disease as their best responses (progressors). HPD was identified in 18 (26.5% of progressors, 14.4% of total) patients. Relatively younger age, primary tumor of oral cavity, and previous locoregional irradiation were significant predictors of HPD according to multivariable analysis (p = 0.040, 0.027, and 0.015, respectively). Compared to patients without HPD, patients with HPD had significantly shorter median progression-free survival (PFS) (1.2 vs. 3.4 months,p < 0.001) and overall survival (OS) (3.4 vs. 10.7 months,p = 0.047). However, interestingly, HPD did not significantly affect the therapeutic benefit of post-ICIs chemotherapy. Conclusions Younger patients with oral cavity cancer or prior treatment with locoregional radiotherapy could be regarded potential risk groups for HPD in patients with R/M-HNSCC treated with ICIs. Although HPD could consistently predict poorer survival outcomes, patients who experienced HPD with ICIs should not be excluded from the subsequent salvage chemotherapy treatments.
- DOI
- 10.1007/s00432-020-03316-5
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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