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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, JihyunChun, Sang HoonLee, Yun-GyooChang, HyunLee, Keun-WookKim, Hye RyunShin, Seong HoonAn, Ho JungLee, Kyoung EunHwang, In GyuAhn, Myung-JuKim, Sung-BaeKeam, Bhumsuk
Ewha Authors
이경은
SCOPUS Author ID
이경은scopusscopus
Issue Date
2020
Journal Title
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
ISSN
0171-5216JCR Link

1432-1335JCR Link
Citation
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY vol. 146, no. 12, pp. 3359 - 3369
Keywords
Hyperprogressive diseaseImmune-checkpoint inhibitorsPrognosticImpactRecurrent andor metastaticHead and neck squamous carcinoma
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS 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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