Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literature
Background. Hyperprogressive disease (HPD) is a new phenomenon that has emerged in the immunotherapy era. HPD is defined as a rapid tumour growth with detrimental effect on the patient condition and disease course. The management and treatment following HPD is not defined. We present here the case r...
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| Format: | Article |
| Language: | English |
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Palacký University Olomouc, Faculty of Medicine and Dentistry
2023-12-01
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| Series: | Biomedical Papers |
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| Online Access: | https://biomed.papers.upol.cz/artkey/bio-202304-0012_hyperprogression-on-anti-pd-1-treatment-is-subsequent-therapy-feasible-a-case-report-and-review-of-the-liter.php |
| _version_ | 1827589548488523776 |
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| author | Jan Skacel Bohuslav Melichar Beatrice Mohelnikova-Duchonova Radmila Lemstrova |
| author_facet | Jan Skacel Bohuslav Melichar Beatrice Mohelnikova-Duchonova Radmila Lemstrova |
| author_sort | Jan Skacel |
| collection | DOAJ |
| description | Background. Hyperprogressive disease (HPD) is a new phenomenon that has emerged in the immunotherapy era. HPD is defined as a rapid tumour growth with detrimental effect on the patient condition and disease course. The management and treatment following HPD is not defined. We present here the case report of patient with HPD and review of the literature on putative mechanisms of HPD and following disease management.
Methods and Results. A 60-year old male patient with metastatic melanoma was indicated for systemic treatment with anti-programmed cell death (PD)-1 antibody. Rapid tumour growth and detrimental effect on the patient general condition after administration of a single dose of anti-PD-1 antibody met the criteria of HPD. The patient underwent the second line taxane-based chemotherapy with good tolerance and disease stabilization. The third line treatment with anti- cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) antibody ipilimumab was well tolerated and resulted in partial response. Re-challenge with anti-CTLA-4 antibody was feasible, but only with a modest clinical effect.
Conclusion. Prompt recognition of HPD and administration of salvage chemotherapy with taxane-based regimens may be crucial. HPD is rarely observed with ipilimumab treatment. Administration of ipilimumab as well as an ipilimumab re-challenge are feasible after HPD on anti-PD-1 antibodies. Investigation of new predictive biomarkers of HPD is warranted as well as new agents that potentiate the immune response in patients affected with this insidious complication. |
| first_indexed | 2024-03-09T01:03:37Z |
| format | Article |
| id | doaj.art-4afbc63683ce4b01b1fd8c2398437510 |
| institution | Directory Open Access Journal |
| issn | 1213-8118 1804-7521 |
| language | English |
| last_indexed | 2024-03-09T01:03:37Z |
| publishDate | 2023-12-01 |
| publisher | Palacký University Olomouc, Faculty of Medicine and Dentistry |
| record_format | Article |
| series | Biomedical Papers |
| spelling | doaj.art-4afbc63683ce4b01b1fd8c23984375102023-12-11T12:59:47ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212023-12-01167437638410.5507/bp.2022.025bio-202304-0012Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literatureJan Skacel0Bohuslav Melichar1Beatrice Mohelnikova-Duchonova2Radmila Lemstrova3Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Zdravotniku 7, 779 00 Olomouc, Czech RepublicDepartment of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Zdravotniku 7, 779 00 Olomouc, Czech RepublicDepartment of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Zdravotniku 7, 779 00 Olomouc, Czech RepublicDepartment of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Zdravotniku 7, 779 00 Olomouc, Czech RepublicBackground. Hyperprogressive disease (HPD) is a new phenomenon that has emerged in the immunotherapy era. HPD is defined as a rapid tumour growth with detrimental effect on the patient condition and disease course. The management and treatment following HPD is not defined. We present here the case report of patient with HPD and review of the literature on putative mechanisms of HPD and following disease management. Methods and Results. A 60-year old male patient with metastatic melanoma was indicated for systemic treatment with anti-programmed cell death (PD)-1 antibody. Rapid tumour growth and detrimental effect on the patient general condition after administration of a single dose of anti-PD-1 antibody met the criteria of HPD. The patient underwent the second line taxane-based chemotherapy with good tolerance and disease stabilization. The third line treatment with anti- cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) antibody ipilimumab was well tolerated and resulted in partial response. Re-challenge with anti-CTLA-4 antibody was feasible, but only with a modest clinical effect. Conclusion. Prompt recognition of HPD and administration of salvage chemotherapy with taxane-based regimens may be crucial. HPD is rarely observed with ipilimumab treatment. Administration of ipilimumab as well as an ipilimumab re-challenge are feasible after HPD on anti-PD-1 antibodies. Investigation of new predictive biomarkers of HPD is warranted as well as new agents that potentiate the immune response in patients affected with this insidious complication.https://biomed.papers.upol.cz/artkey/bio-202304-0012_hyperprogression-on-anti-pd-1-treatment-is-subsequent-therapy-feasible-a-case-report-and-review-of-the-liter.phphyperprogressive diseasenivolumabipilimumabmelanomapaclitaxel |
| spellingShingle | Jan Skacel Bohuslav Melichar Beatrice Mohelnikova-Duchonova Radmila Lemstrova Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literature Biomedical Papers hyperprogressive disease nivolumab ipilimumab melanoma paclitaxel |
| title | Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literature |
| title_full | Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literature |
| title_fullStr | Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literature |
| title_full_unstemmed | Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literature |
| title_short | Hyperprogression on anti-PD-1 treatment. Is subsequent therapy feasible? A case report and review of the literature |
| title_sort | hyperprogression on anti pd 1 treatment is subsequent therapy feasible a case report and review of the literature |
| topic | hyperprogressive disease nivolumab ipilimumab melanoma paclitaxel |
| url | https://biomed.papers.upol.cz/artkey/bio-202304-0012_hyperprogression-on-anti-pd-1-treatment-is-subsequent-therapy-feasible-a-case-report-and-review-of-the-liter.php |
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