Hyperprogressive disease and its clinical impact in patients with recurrent and/or metastatic head and neck squamous cel
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Hyperprogressive disease and its clinical impact in patients with recurrent and/or metastatic head and neck squamous cell carcinoma treated with immune‑checkpoint inhibitors: Korean cancer study group HN 18–12 Jihyun Park1 · Sang Hoon Chun2 · Yun‑Gyoo Lee3 · Hyun Chang4 · Keun‑Wook Lee5 · Hye Ryun Kim6 · Seong Hoon Shin7 · Ho Jung An8 · Kyoung Eun Lee9 · In Gyu Hwang10 · Myung‑Ju Ahn11 · Sung‑Bae Kim12 · Bhumsuk Keam13 Received: 21 April 2020 / Accepted: 8 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Although immune-checkpoint inhibitors (ICIs) have emerged as therapeutic options for recurrent and/or metastatic head and neck squamous cell carcinoma (R/M-HNSCC), concerns have been raised on exceptional acceleration of tumor growth during treatment with ICIs, a condition described as hyperprogressive disease (HPD). This study examined the incidence, potential predictors, and clinical impact of HPD in R/M-HNSCC. Methods We retrospectively collected data of patients with R/M-HNSCC treated with ICIs between January 2013 and June 2018 from 11 medical centers in Korea. HPD was defined as tumor growth kinetics ratio (TGKr) > 2, which was calculated by comparing TGK on ICIs with that before treatment with ICIs. Results Of 125 patients, 68 (54.4%) obtained progressive disease as their best responses (progressors). HPD was identified in 18 (26.5% of progressors, 14.4% of total) patients. Relatively younger age, primary tumor of oral cavity, and previous locoregional irradiation were significant predictors of HPD according to multivariable analysis (p = 0.040, 0.027, and 0.015, respectively). Compared to patients without HPD, patients with HPD had significantly shorter median progression-free survival (PFS) (1.2 vs. 3.4 months, p 4 vs. ≤ 4 Stage at ICIs initiation IV C vs. IV A/B Number f distant metastases > 2 vs. ≤ 2 Presence of liver metastasis Yes vs. No Pattern of relapse Locoregional only vs. distant Prior locoregional radiotherapy Yes vs. No Prior lines of systemic therapy ≥ 2 vs.
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