Durvalumab-Induced Hyperprogressive Disease in Nonmetastatic Lung Cancer

Hyperprogressive disease in lung metastases without target lesion progression after durvalumab consolidation therapy: A case report

“…To our knowledge, there is only one reported case of HPD in which new distant metastases appeared despite the tumor at the original site not increasing in size. 5 Importantly, in that case, the peculiar HPD occurred just after the patient received ICI subsequent to chemoradiotherapy. Therefore, when administering ICIs to patients who have received radiation therapy, attention is required to detect the sudden development of multiple distant metastases early after ICI administration.…”

“…This mechanism would suppress HPD more in the target lesion than in the nontarget lesion, causing discrepancy between the target lesion and new metastasis. To our knowledge, there is only one reported case of HPD in which new distant metastases appeared despite the tumor at the original site not increasing in size 5 . Importantly, in that case, the peculiar HPD occurred just after the patient received ICI subsequent to chemoradiotherapy.…”

“…Tariq et al reported a case in which multiple brain metastases and left adrenal gland metastasis appeared as HPD, despite a reduction in the target lesion size, 4 weeks after the introduction of durvalumab following chemoradiotherapy. 5 Further elucidation of the pathophysiology and a more refined definition of HPD are needed to determine whether these cases are truly HPD. Second, even when ICIs are administered as consolidation therapy after chemoradiotherapy, HPD may occur.…”

“…However, the pathophysiology of HPD is still unclear, and there is no unified definition. Tariq et al reported a case in which multiple brain metastases and left adrenal gland metastasis appeared as HPD, despite a reduction in the target lesion size, 4 weeks after the introduction of durvalumab following chemoradiotherapy 5 . Further elucidation of the pathophysiology and a more refined definition of HPD are needed to determine whether these cases are truly HPD.…”

Hyperprogressive disease in non-small cell lung cancer after PD-1/PD-L1 inhibitors immunotherapy: underlying killer

“…For instance, although the PD-1 antibody Nivolumab is quite effective in clinical practice, HPD is not rare in patients with advanced NSCLC treated with Nivolumab and paralleled with a poor prognosis ( 6 , 7 ). There are also several case reports about HPD events after treatment with another PD-1 inhibitor Pembrolizumab and the PD-L1 inhibitor - Durvalumab ( 8 , 9 ). However, the definition and predictive biomarkers of HPD in NSCLC remain controversial, and the associated clinicopathological features or biological mechanisms are not yet determined.…”