Is there an association between lymph node size and hyperprogression in immunotherapy-treated patients?

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Romanian Journal of Internal Medicine Pub Date : 2024-03-23 Print Date: 2024-03-01 DOI:10.2478/rjim-2023-0025
Mohammad S Alkader, Rashed Z Altaha, Eslam H Jabali, Ola A Attieh, Ala' W Matalqa
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Abstract

Background: Hyperprogressive disease (HPD) can be described as an accelerated increase in the growth rate of tumors combined with rapid clinical deterioration observed in a subset of cancer patients undergoing immunotherapy, specifically with immune checkpoint inhibitors (ICIs). The reported incidence of HPD ranges from 5.9% to 43.1% in patients receiving ICIs. In this context, identifying reliable predictive risk factors for HPD is crucial as it may allow for earlier intervention and ultimately improve patient outcomes.

Methods: This study retrospectively analyzed ten metastatic renal cell carcinoma (mRCC) patients. The identification of HPD was based on the diagnostic criteria proposed by Ferrara R et al. This study aimed to investigate whether there is an association between LN size and HPD using a cutoff value of 3 cm for LN size. Given the limited sample size, Fisher's exact test was used to test this association. We conducted a Kaplan-Meier (KM) analysis to estimate the median overall survival (OS) of patients with HPD and compared it to those without HPD.

Results: Three patients (30%) developed HPD, while seven (70%) did not. Fisher's exact test revealed a statistically significant association between the HPD and LN size ≥ 3 cm (p=0.008). In the HPD group, the median OS was significantly shorter, with a median OS of 3 months, whereas in the non-HPD group, the median OS was not reached (P =0.001).

Conclusion: The present study found a significant association between LN size ≥ 3 cm in the pretreatment period and HPD development.

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免疫治疗患者的淋巴结大小和过度进展之间是否存在关联?
背景:超进行性疾病(HPD)可被描述为在接受免疫疗法(特别是免疫检查点抑制剂(ICIs))的癌症患者中观察到的肿瘤生长率加速增加,并伴有临床快速恶化。据报道,在接受ICIs的患者中,HPD的发病率在5.9%-43.1%之间。在这种情况下,确定HPD的可靠预测风险因素至关重要,因为它可以更早地进行干预,并最终改善患者的预后。方法:本研究回顾性分析了10例转移性肾细胞癌(mRCC)患者。HPD的鉴定基于Ferrara R等人提出的诊断标准。本研究旨在研究LN大小与HPD之间是否存在关联,LN大小的临界值为3cm。在样本量有限的情况下,使用Fisher精确检验来检验这种关联。我们进行了Kaplan-Meier(KM)分析来估计HPD患者的中位总生存期(OS),并将其与无HPD患者进行了比较。结果:3名患者(30%)出现HPD,7名患者(70%)没有。Fisher精确检验显示,HPD和LN大小≥3cm之间存在统计学显著相关性(p=0.008)。在HPD组中,中位OS明显更短,中位OS3个月,而在非HPD组,中位OS未达到(P=0.001)。结论:本研究发现,治疗前LN大小≥3cm与HPD的发生有显著相关性。
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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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