AI Article Synopsis

  • Immune checkpoint inhibitors (ICIs) are commonly used to treat non-small cell lung cancer (NSCLC), and this study explores the occurrences of pseudoprogression (temporary worsening) and hyperprogression (rapid disease worsening) among patients receiving ICIs.
  • The research involved 74 advanced NSCLC patients at Chungnam National University Hospital, assessing their response to treatment by analyzing chest X-rays and measuring circulating Treg cells in blood samples shortly after starting therapy.
  • Results showed that pseudoprogression occurred in 13.5% and hyperprogression in 8.1% of patients, with significant changes in Treg cell levels suggesting they could serve as a biomarker to differentiate these responses and predict treatment outcomes.

Article Abstract

Background: Immune checkpoint inhibitors (ICIs) have become the standard of care for a variety of cancers, including non-small cell lung cancer (NSCLC). In this study, we investigated the frequency of pseudoprogression and hyperprogression in lung cancer patients treated with ICIs in the real world and aimed to discover a novel candidate marker to distinguish pseudoprogression from hyperprogression soon after ICI treatment.

Methods: This study included 74 patients with advanced NSCLC who were treated with PD-1/PD-L1 inhibitors at Chungnam National University Hospital (CNUH) between January 2018 and August 2020. Chest X-rays were examined on day 7 after the first ICI dose to identify changes in the primary mass, and the response was assessed by computed tomography (CT). We evaluated circulating regulatory T (Treg) cells using flow cytometry and correlated the findings with clinical outcomes.

Results: The incidence of pseudoprogression was 13.5%, and that of hyperprogression was 8.1%. On day 7 after initiation of treatment, the frequency of CD4CD25CD127FoxP3 Treg cells was significantly decreased compared with baseline (P = 0.038) in patients who experienced pseudoprogression and significantly increased compared with baseline (P = 0.024) in patients who experienced hyperprogression. In the responder group, the frequencies of CD4CD25CD127FoxP3 Treg cells and PD-1CD4CD25CD127FoxP3 Treg cells were significantly decreased 7 days after commencement of treatment compared with baseline (P = 0.034 and P < 0.001, respectively).

Conclusion: Circulating Treg cells represent a promising potential dynamic biomarker to predict efficacy and differentiate atypical responses, including pseudoprogression and hyperprogression, after immunotherapy in patients with NSCLC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8854239PMC
http://dx.doi.org/10.1007/s00262-021-03018-yDOI Listing

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