Hyperprogression in Patients With Cancer Receiving Immune Checkpoint Inhibitors
A partir d'une revue systématique de la littérature (24 études, 3 109 patients), cette méta-analyse définit le concept de maladie hyperprogressive et évalue son incidence chez des patients atteints d'un cancer pendant les traitements par inhibiteurs de points de contrôle immunitaire
The development of immune checkpoint inhibitors has revolutionized the field of cancer therapeutics, but it has also brought to forefront the issue of optimal assessment of clinical benefit during treatment with these agents. The use of these immune-activating drugs often can be associated with atypical patterns of therapeutic response, ranging from hyperprogression, pseudoprogression, and dissociated or mixed response to durable clinical responses long after discontinuation of therapy.1 Hyperprogression, which reflects unexpectedly rapid progression of disease in patients receiving immunotherapy (with clinically deleterious implications), has been a topic of intense discussion among oncologists.2,3 With publication of multiple clinical reports of different cancer types worldwide, hyperprogression is now accepted by most oncologists to be a true phenomenon rather than natural progression of disease.1,3 However, major limitations remain in the literature, particularly with regard to heterogeneity in assessment criteria used to define hyperprogression, the retrospective nature of analyses, and the lack of a comparator group in most studies of this phenomenon.
JAMA Network Open , commentaire en libre accès, 2020