Hyper-progressive disease in a patient with advanced non-small cell lung cancer on immune checkpoint inhibitor therapy: A case report and literature review

Lung Cancer. 2020 Jan:139:18-21. doi: 10.1016/j.lungcan.2019.10.026. Epub 2019 Oct 31.

Abstract

Objectives: While immune checkpoint inhibitor (ICI) therapy has excellent efficacy in treating multiple cancers, some patients experience accelerated disease progression, defined as hyper-progressive disease (HPD). However, the characteristics of HPD, especially in patients with non-small-cell lung cancer (NSCLC), remain to be elucidated.

Materials and methods: We report about an advanced NSCLC patient with striking disease progression, defined as HPD by existing standards, after the administration of pembrolizumab. We also reviewed related studies to discuss the definition, relative factors, and prognosis of HPD.

Results and conclusion: This case of NSCLC with HPD had a series of characteristics not widely described in HPD cases previously reported, suggesting the potential complexity of this phenomenon and the necessity to study its characteristics and to more closely monitor patients who are administered ICIs.

Keywords: Checkpoint inhibitor; Hyper-progressive disease; Immunotherapy; Non-small-cell lung cancer.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antineoplastic Agents, Immunological / adverse effects*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Disease Progression
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / pathology*
  • Female
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Prognosis

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors
  • pembrolizumab