超进展性疾病（HPD）是免疫检查点抑制剂（ICI）治疗时代发展的新现象。 HPD 的特点是肿瘤体积意外且快速进展且生存率低。 HPD 没有标准化定义，与 HPD 相关的临床病理学变量尚不清楚。在此，我们评估了接受 ICI 治疗的患者 HPD 的发生率、治疗结果和预测因素。我们回顾性分析了 2014 年至 2021 年间在一个学术中心接受 ICI 治疗的晚期癌症患者。我们使用 Lo Russo 采用的标准，结合临床和放射学HPD 定义的参数。所有根据 RECIST1.1 接受首次肿瘤评估的患者均被纳入。在 155 名患者中，147 名符合分析条件。中位年龄为 61 岁，83% 为男性。癌症类型是：肺癌67.3%，膀胱癌12.9%，胃癌9.5%，5%，结肠癌5.4%，肾细胞癌4.8%。 59.9% 的患者未接受过治疗，其他患者接受过一种或多种化疗。 19 名 (12.9%) 患者患有 HPD。在患有 HPD 的患者中，无进展生存期 (PFS) 显着缩短（1.5 个月与 9.8 个月，（HR 9.56；95% CI (5.51-16.57)，p<0.001）。中位总生存期 (OS) 也较短HPD 患者比非 HPD 患者（分别为 3.0 个月和 23.1 个月，HR 12.03，95% CI (6.64-21.81)，p< 0.001）。较高的中性粒细胞-淋巴细胞比率 (NLR) 与 HPD 显着相关。我们的研究结果表明，HPD 是一种快速现象，且存活率显着降低。一些临床病理因素和肿瘤特征可能表明 HPD。© 2024。作者，下。 Federación de Sociedades Españolas de Oncología (FESEO) 的独家许可。

Hyperprogressive disease (HPD) is a new phenomenon developing in the era of immune checkpoint inhibitor (ICI) therapy. HPD is characterized by an unexpected and fast progression in tumor volume and poor survival. There is no standardized definition for HPD and clinicopathological variables associated with HPD are unclear. Herein, we assessed incidence, treatment outcomes and factors predictive of HPD in patients treated with ICIs.We retrospectively analyzed patients with advanced cancer treated with ICI at one academic center between 2014 and 2021. We used the Lo Russo's adopted criteria combined with clinical and radiologic parameters for the definition of HPD. All patients who underwent their first tumor evaluation according to RECIST1.1 were included.Of 155 patients, 147 were eligible for analysis. The median age was 61 and 83% were male. The cancer types were; lung 67.3%, bladder 12.9%, gastric 9.5%, 5, colon 5.4% and renal cell carcinoma 4.8%. 59.9% of patients were treatment-naive and others had one or more lines of chemotherapy. 19 (12.9%) patients had HPD. In patients who had HPD, progression-free survival (PFS) was significantly shorter (1.5 vs 9.8 months, (HR 9.56; 95% CI (5.51-16.57), p < 0.001). The median overall survival (OS) was also shorter for HPD patients than non-HPD (3.0 vs 23.1 months, respectively, HR 12.03, 95% CI (6.64-21.81), p < 0.001). Gastric cancer, larger sum of target lesion diameters at baseline, liver metastases, higher LDH level and higher neutrophil-lymphocyte ratio (NLR) were significantly associated with HPD.Our findings demonstrated that HPD was a rapid phenomenon with significantly poor survival rates. Several clinicopathological factors and tumor characteristics might indicate HPD.© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).