Clinical analysis of hyperprogression of metastatic malignant melanoma induced by toripalimab
- VernacularTitle:特瑞普利单抗致转移性恶性黑色素瘤超进展的临床分析
- Author:
Rong DUAN
1
;
Bixia TANG
1
;
Siming LI
1
;
Xieqiao YAN
1
;
Xinan SHENG
1
;
Chuanliang CUI
1
;
Lu SI
1
;
Li ZHOU
1
;
Lili MAO
1
;
Bin LIAN
1
;
Xuan WANG
1
;
Xue BAI
1
;
Huayan XU
1
;
Zhonghui QI
1
;
Caili LI
1
;
Jun GUO
1
;
Zhihong CHI
1
Author Information
- Publication Type:Journal Article
- Keywords: Melanoma; Antineoplastic agents, immunological; Programmed cell death 1 receptor; Hyperprogression
- From: Adverse Drug Reactions Journal 2020;22(10):553-558
- CountryChina
- Language:Chinese
- Abstract: Objective:To explore the occurrence and clinical characteristics of hyperprogression of metastatic malignant melanoma caused by toripalimab (JS001).Methods:The medical records of patients with metastatic malignant melanoma treated with JS001 alone or in combination with other antineoplastic agents between February 2018 and September 2019 in Department of Kidney Cancer and Melanoma of Beijng Cancer Hospital were collected. Patients displaying hyperprogression were screened into the case group, who were matched with those without hyperprogression evidence (the control group) in a 1/4 ratio according to baseline age, gender, Eastern Cooperative Oncology Group score, location of the primary lesion, and elevated level of lactate dehydrogenase (LDH). The clinical characteristics and prognosis of patients between the 2 groups were compared and the hyperprogression in the case group was analyzed descriptively.Results:A total of 130 patients with metastatic malignant melanoma who received JS001 alone or in combination with other antineoplastic agents were collected. Hyperprogression occurred in 8 patients (the case group), including 5 males and 3 females, aged (52.5±8.5) years. The incidence of hyperprogression was 6.15%. Thirty-two patients without displaying hyperprogression were matched as the control group according to the baseline characteristics of patients in the case group. Patients with metastatic lesions in more than 2 organs at baseline in the case group were significantly more than those in the control group (6/8 vs. 7/32, P=0.014); the LDH level of patients in the case group significantly increased after treatment than before [(965±710) U/L vs. (264±64) U/L, P=0.025]; the progression-free survival and overall survival in patients were significantly lower than those of patients in the control group [1.7 (95 %CI: 1.4-2.0) months vs. 3.1 (95 %CI: 2.7-3.5) months, P<0.001; 4.8 (95 %CI: 0-11.2) months vs. 10.7 (95 %CI: 10.4-10.9) months, P=0.031]. Conclusions:Patients with melanoma may experience hyperprogression in early stages of JS001 treatment. Patients with metastatic lesions in more than 2 organs before treatment are more likely to develop hyperprogression, and patients displaying hyperprogression have a poor prognosis. Serum LDH level monitoring can help detect tumor hyperprogression as early as possible.
