Yutaro Kubota1, Kiyoshi Yoshimura2,3, Kazuyuki Hamada1, Yuya Hirasawa1, Midori Shida3, Makoto Taniguchi3, Hiroto Matsui4, Hirotsugu Ariizumi1, Tomoyuki Ishiguro1, Norihiro Suzuki5, Ryotaro Ohkuma1, Takehiko Sambe6, Hiroo Ishida1, Atsushi Horiike1, Satoshi Wada1,7, Junji Tsurutani1,8, Sanju Iwamoto9, Naoki Uchida6, Yuji Kiuchi10, Shinichi Kobayashi11, Takuya Tsunoda1. 1. Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. 2. Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan; kyoshim1@med.showa-u.ac.jp. 3. Department of Clinical Immuno-Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan. 4. Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. 5. Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. 6. Division of Clinical Pharmacology, Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan. 7. Department of Clinical Diagnostic Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan. 8. Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan. 9. Department of Biochemistry, Showa University School of Medicine, Tokyo, Japan. 10. Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan. 11. Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan.
Abstract
BACKGROUND/AIM: Rapid tumor growth after administration of immune checkpoint inhibitors is designated hyper progressive disease (HPD). In this study, besides the conventional HPD category, we proposed the "super HPD" category where the disease is naturally rapidly growing. PATIENTS AND METHODS: Patients treated for advanced gastric cancer with irinotecan or nivolumab as a third-line treatment were retrospectively compared. RESULTS: Eighteen and 26 patients were treated with irinotecan or nivolumab, respectively. There were 3 HPD cases (16.7%) in the irinotecan group, 6 cases (23.1%) in the nivolumab group, and the frequency of HPD was not significantly different. Two cases satisfied the super HPD definition only in the nivolumab group. When one of them was analyzed immunologically, the number of regulatory T cells was found to be increased, resulting in a low neutrophil-to-lymphocyte ratio. CONCLUSION: Our proposed super HPD was likely to represent a true HPD, with a frequency of 7.7%. Copyright
BACKGROUND/AIM: Rapid tumor growth after administration of immune checkpoint inhibitors is designated hyper progressive disease (HPD). In this study, besides the conventional HPD category, we proposed the "super HPD" category where the disease is naturally rapidly growing. PATIENTS AND METHODS: Patients treated for advanced gastric cancer with irinotecan or nivolumab as a third-line treatment were retrospectively compared. RESULTS: Eighteen and 26 patients were treated with irinotecan or nivolumab, respectively. There were 3 HPD cases (16.7%) in the irinotecan group, 6 cases (23.1%) in the nivolumab group, and the frequency of HPD was not significantly different. Two cases satisfied the super HPD definition only in the nivolumab group. When one of them was analyzed immunologically, the number of regulatory T cells was found to be increased, resulting in a low neutrophil-to-lymphocyte ratio. CONCLUSION: Our proposed super HPD was likely to represent a true HPD, with a frequency of 7.7%. Copyright
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