Zhang Haochen, Fang Xuefeng, Li Dan, Yang Mengyuan, Yu Linzhen, Ding Yuwei, Shen Hong, Yuan Ying
Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Curr Probl Cancer. 2021 Jun;45(3):100688. doi: 10.1016/j.currproblcancer.2020.100688. Epub 2020 Dec 9.
Hyperprogressive disease (HPD) is an unexpected response pattern observed in immune checkpoint therapy and associated with poor prognosis in several cancers. Such patients can't benefit from immunotherapy and even experience a rapid disease progression. At present, many researchers have explored the HPD phenomenon, but there is no consensual definition of HPD in different studies. The incidence of HPD is about 4%-29% in various tumors. Many studies demonstrated that HPD was associated with worse prognosis, but the mechanism of HPD has not yet been fully clarified. Predictive factors in patients with HPD before treatment is one of the keys to managing patients receiving immune checkpoint inhibitors. Some factors, such as MDM2/4 amplification, EGFR mutations, and old age may be risk factors for HPD, but the results are discordant in different studies. Performing imaging evaluation and biopsy as early as possible is the main method to avoid the iatrogenic injury of immunotherapy at present.
超进展性疾病（HPD）是免疫检查点治疗中观察到的一种意外反应模式，与多种癌症的不良预后相关。这类患者无法从免疫治疗中获益，甚至会经历疾病的快速进展。目前，许多研究人员对HPD现象进行了探索，但不同研究中对HPD尚无共识性定义。HPD在各种肿瘤中的发生率约为4%-29%。许多研究表明，HPD与更差的预后相关，但HPD的机制尚未完全阐明。治疗前HPD患者的预测因素是管理接受免疫检查点抑制剂治疗患者的关键之一。一些因素，如MDM2/4扩增、EGFR突变和老年可能是HPD的危险因素，但不同研究的结果并不一致。尽早进行影像学评估和活检是目前避免免疫治疗医源性损伤的主要方法。
