Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, 200433, China.
Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
BMC Cancer. 2020 Jul 29;20(1):707. doi: 10.1186/s12885-020-07206-4.
A number of studies have reported hyperprogressive disease (HPD) in non-small cell lung cancer (NSCLC) after treatment with immune checkpoint inhibitor (ICI). This study aimed to summarize the incidence and survival outcome of HPD in NSCLC and identify the clinicopathological features associated with HPD based on available eligible studies.
Four databases (Medline/PubMed, Embase, Web of Science, and Cochrane Library) were searched for eligible studies on HPD published before January 23, 2020, to evaluate the incidence, outcome, and clinical features of HPD. Statistical analyses were performed using STATA 15.0. All meta-analyses were performed based on the random-effects model.
This study included 6 studies involving 1389 patients. The incidence of HPD ranged from 8.02 to 30.43%. Compared with patients with non-HPD, those with HPD were associated with worse overall survival. We identified that Eastern Cooperative Oncology Group > 1, Royal Marsden Hospital score ≥ 2, serum lactate dehydrogenase > upper limit of normal, the number of metastasis sites > 2, and liver metastasis were associated with the risk of HPD.
This study summarized the clinical features of HPD in NSCLC patients. The meta-analysis showed that five pre-treatment clinicopathological features might be associated with HPD, which may help in selecting patients for ICIs.
一些研究报告称，在接受免疫检查点抑制剂（ICI）治疗后，非小细胞肺癌（NSCLC）出现了超进展性疾病（HPD）。本研究旨在总结 NSCLC 中 HPD 的发生率和生存结局，并根据现有合格研究确定与 HPD 相关的临床病理特征。
检索了 Medline/PubMed、Embase、Web of Science 和 Cochrane Library 四个数据库，以查找截至 2020 年 1 月 23 日发表的关于 HPD 的合格研究，以评估 HPD 的发生率、结局和临床特征。使用 STATA 15.0 进行统计分析。所有荟萃分析均基于随机效应模型进行。
本研究纳入了 6 项涉及 1389 例患者的研究。HPD 的发生率为 8.02%至 30.43%。与非 HPD 患者相比，HPD 患者的总体生存率更差。我们发现，东部肿瘤协作组>1、皇家马斯登医院评分≥2、血清乳酸脱氢酶>正常值上限、转移部位>2 个和肝转移与 HPD 的风险相关。
本研究总结了 NSCLC 患者 HPD 的临床特征。荟萃分析表明，五种治疗前临床病理特征可能与 HPD 相关，这可能有助于选择接受 ICI 治疗的患者。
