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Tae-Won Jang
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P75 - Immunotherapy (Phase II/III Trials) - Misc. Topics (ID 248)
- Event: WCLC 2020
- Type: Posters
- Track: Immunotherapy (Phase II/III Trials)
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P75.13 - Hyperprogressive Disease in Non-Small Cell Lung Cancer on pd-1 Inhibitor. (ID 1872)
00:00 - 00:00 | Presenting Author(s): Tae-Won Jang
- Abstract
Introduction
PD-1 inhibitor has brought new paradigm to the treatment of non-small cell lung cancer. Immunotherapy showed better quality of life and survival compared to standard cytotoxic chemotherapy. Though in some patients during immunotherapy, there was a new disease pattern called hyperprogressive disease (HPD). Now, there are many definitions of HPD. Among them, we defined HPD as cases of treatment failure within 2 months and tumor size increased by more than 50%. This study aimed to investigate the characteristics of HPD patients and identify factors associated with HPD in non-small cell lung cancer on pd-1 inhibitor
Methods
We performed a retrospective clinical and radiological analysis of non-small cell lung cancer patients treated with PD-1 inhibitor (Nivolumab or Pembrolizumab) at Kosin university gospel hospital (July 2017 to Mar 2019). 64 patients were enrolled. We classified into HPD and non-HPD by treatment failure in 2 month and over 50% tumor growth. CXR or CT scans were analyzed in term of tumor growth by comparing previous vs post PD-1 inhibitor.
Results
Median age was 65.9 years and almost patients were male (82.8%) and half of patients were ever smoker (56.25%). Adenocarcinoma was 53% (n=34). HPD was detected in 12 (18%). Overall response rate was 25% (n=16) and disease control rate was 48.4% (n=31). PD-L1 expression of both groups, SP263 value was similar (47.7% vs 45.5%, respectively non-HPD and HPD). There were no clinical factors specific for HPD. Only, we found increasing the probability bone metastasis was seen in HPD group compared to non-HPD (50% vs 28.8%, p=0.287). Median TTF time was 5.5 month in non-HPD and 1.6 month in HPD group. All 12 HPD patients were expired in 3 months from PD-1 inhibitor treatment.
Conclusion
HPD is a subset type of response in NSCLC patients treated by PD-1 inhibitors. This study showed prognosis of HPD patients was very poor but found no statistically significant factors that could be affect HPD. There has not yet been a large-scale study of risk factors for HPD. This still requires caution in immunotherapy. Additional studies are needed for determine the patients treated with PD-1 inhibitors.
