Hyperprogression of brain metastases following initiation of immune checkpoint inhibitors.

IF 3.1 2区医学 Q2 CLINICAL NEUROLOGY Journal of Neuro-Oncology Pub Date : 2025-05-01 Epub Date: 2025-02-07 DOI:10.1007/s11060-025-04955-9

Charissa A C Jessurun, Francesca Siddi, Noah L A Nawabi, Alexander F C Hulsbergen, Yu Tung Lo, Rohan Jha, Timothy R Smith, Marike L D Broekman

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Abstract

Purpose: Immune checkpoint inhibitors (ICI) are increasingly being administered to cancer patients, including those with brain metastases (BMs). However, in a subset of cancer patients, ICI have shown to paradoxically accelerate tumor growth. This phenomenon is known as hyperprogressive disease (HPD). The aim of this study is to investigate the occurrence of HPD following initiation of ICI in BM patients.

Methods: We retrospectively reviewed the charts of 60 surgically treated patients with BMs from non-small cell lung cancer or melanoma who were administered ICI at the Brigham and Women's Hospital, Boston between July 2008 and July 2018. BM tumor volumes before and after initiation of ICI were collected. HPD was defined as a 'post-immunotherapy' tumor growth rate (TGR) > 2 times 'pre-immunotherapy' TGR within three months following initiation of ICI.

Results: Among the 25 included patients treated with ICI, five patients showed HPD with an increase of post-immunotherapy TGR ranging from 4.9 to 207.7 times the pre-immunotherapy TGR. The median survival after initiation of ICI was was 8.0 months in the HPD cases and 13 months in the non-HPD patients.

Conclusion: HPD occurred in about 20% of BM patients receiving ICI. More research is necessary to prospectively analyze the occurrence of HPD and identify predictive factors for HPD in BM patients.

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免疫检查点抑制剂启动后脑转移的超进展。

目的：免疫检查点抑制剂（ICI）越来越多地用于癌症患者，包括脑转移（BMs）患者。然而，在一部分癌症患者中，ICI却自相矛盾地加速了肿瘤的生长。这种现象被称为超进行性疾病（HPD）。本研究的目的是调查BM患者开始ICI后HPD的发生情况。方法：我们回顾性回顾了2008年7月至2018年7月在波士顿布里格姆妇女医院接受ICI治疗的60例非小细胞肺癌或黑色素瘤脑转移手术患者的图表。收集ICI开始前后BM肿瘤体积。HPD被定义为ICI开始后3个月内“免疫治疗后”肿瘤生长速率（TGR）为“免疫治疗前”TGR的2倍。结果：在25例接受ICI治疗的患者中，5例患者出现HPD，免疫治疗后TGR比免疫治疗前TGR增加4.9 - 207.7倍。HPD患者开始ICI治疗后的中位生存期为8.0个月，非HPD患者为13个月。结论：在接受ICI治疗的BM患者中，HPD发生率约为20%。需要更多的研究来前瞻性分析BM患者HPD的发生，并确定HPD的预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuro-Oncology 医学-临床神经学

CiteScore

6.60

自引率

7.70%

发文量

277

审稿时长

3.3 months

期刊介绍： The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.