Rare Nivolumab-associated Super Hyper Progressive Disease in Patients With Advanced Gastric Cancer.

Abstract

BACKGROUND/AIM:

Rapid tumor growth after administration of immune checkpoint inhibitors is designated hyper progressive disease (HPD). In this study, besides the conventional HPD category, we proposed the "super HPD" category where the disease is naturally rapidly growing.

PATIENTS AND METHODS:

Patients treated for advanced gastric cancer with irinotecan or nivolumab as a third-line treatment were retrospectively compared.

RESULTS:

Eighteen and 26 patients were treated with irinotecan or nivolumab, respectively. There were 3 HPD cases (16.7%) in the irinotecan group, 6 cases (23.1%) in the nivolumab group, and the frequency of HPD was not significantly different. Two cases satisfied the super HPD definition only in the nivolumab group. When one of them was analyzed immunologically, the number of regulatory T cells was found to be increased, resulting in a low neutrophil-to-lymphocyte ratio.

CONCLUSION:

Our proposed super HPD was likely to represent a true HPD, with a frequency of 7.7%.

• Authors: Yutaro Kubota, Kiyoshi Yoshimura, Kazuyuki Hamada, Yuya Hirasawa, Midori Shida, Makoto Taniguchi, Hiroto Matsui, Hirotsugu Ariizumi, Tomoyuki Ishiguro, Norihiro Suzuki, Ryotaro Ohkuma, Takehiko Sambe, Hiroo Ishida, Atsushi Horiike, Satoshi Wada, Junji Tsurutani, Sanju Iwamoto, Naoki Uchida, Yuji Kiuchi, Shinichi Kobayashi, Takuya Tsunoda
• Journal: In vivo (Athens, Greece) (In Vivo) 2021 May-Jun Vol. 35 Issue 3 Pg. 1865-1875 ISSN: 1791-7549 [Electronic] Greece
• PMID: 33910874 (Publication Type: Journal Article)
• Copyright: Copyright© 2021, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Chemical References

• Antineoplastic Agents, Immunological
• Nivolumab

Topics

• Antineoplastic Agents, Immunological (adverse effects)
• Humans
• Lymphocytes
• Nivolumab (adverse effects)
• Retrospective Studies
• Stomach Neoplasms (drug therapy)