Targeted timeout.

Before we start adding lead-tagged PD-1 axis inhibitors to our drinking water, lets not forget their not-so-magical effects. This multi-center French retrospective study takes a look at hyperprogressive disease (HPD) in patients receiving PD-1 axis inhibitors for non-small cell lung cancer (NSCLC). HPD means accelerated tumor growth when switching from a cytotoxic agent to salvage immunotherapy, and here it was defined as >50% increase in tumor growth rate from pre-immunotherapy. New lesions weren’t considered in the HPD analysis and tumors that subsequently regressed without changes in therapy were also excluded as pseudoprogression. Among over 400 patients, 65% showed initial response and 35% progression. After accounting for a ~5% rate of pseudoprogression, the overall rate of HPD with immunotherapy was 14% versus 5% treated with second-line cytotoxic chemo. TBL: Hyperprogressive disease is not infrequent among patients with NSCLC receiving immunotherapy, and it portends worse overall survival. | Ferrara, JAMA Oncol 2018