Karabajakian Andy, Garrivier Thibaut, Crozes Carole, Gadot Nicolas, Blay Jean-Yves, Bérard Frédéric, Céruse Philippe, Zrounba Philippe, Saintigny Pierre, Mastier Charles, Fayette Jérôme
Department of Medical Oncology, Centre Léon Bérard, Lyon, France.
Department of Radiology, Centre Léon Bérard, Lyon, France.
Oncotarget. 2020 May 5;11(18):1618-1628. doi: 10.18632/oncotarget.27563.
Hyperprogressive disease (HPD) rate in head and neck squamous cell carcinoma (HNSCC) patients treated with immune checkpoint inhibitors (ICI) was determined using tumor growth kinetics (TGK) and compared with rapidly progressive screen-failure (SF) patients. The impact of TGK on outcomes with salvage chemotherapy (SCT) was also evaluated. HPD was found in 22/120 (18%) patients. Median TGK before the onset of immunotherapy (TGK) was 2.7 for SF patients and 4.8 for HPD patients, with no significant difference ( = 0.17). Disease control rate after initial progressive disease on ICI was 86% with SCT in case of tumor growth deceleration vs 39% in case of tumor growth acceleration. HPD was frequent, but TGK of HPD patients treated with ICI did not differ from SF patients, suggesting that there is no relevant causal relationship between HPD and ICI. After initial PD with ICI, tumor growth deceleration was associated with better outcomes, indicating that TGK might be useful to detect late responders, meriting prospective investigations. TGK ratio (TGK) was defined as the ratio of TGK on ICI (TGK) to TGK. HPD was defined as TGK ≥ 2. TGK >1 indicated tumor growth acceleration, while 0 < TGK < 1 indicated tumor deceleration.
采用肿瘤生长动力学（TGK）测定接受免疫检查点抑制剂（ICI）治疗的头颈部鳞状细胞癌（HNSCC）患者的超进展性疾病（HPD）发生率，并与快速进展性筛查失败（SF）患者进行比较。还评估了TGK对挽救性化疗（SCT）结局的影响。在120例患者中有22例（18%）发现HPD。免疫治疗开始前的中位TGK，SF患者为2.7，HPD患者为4.8，无显著差异（P = 0.17）。ICI治疗后初始疾病进展时，肿瘤生长减速情况下SCT后的疾病控制率为86%，而肿瘤生长加速情况下为39%。HPD很常见，但接受ICI治疗的HPD患者的TGK与SF患者无差异，这表明HPD与ICI之间不存在相关因果关系。ICI治疗后初始疾病进展后，肿瘤生长减速与更好的结局相关，这表明TGK可能有助于检测延迟反应者，值得进行前瞻性研究。TGK比值（TGK）定义为ICI治疗时的TGK（TGK）与TGK的比值。HPD定义为TGK≥2。TGK>1表明肿瘤生长加速，而0<TGK<1表明肿瘤减速。
