Nivolumab-refractory patients with advanced non-small-cell lung cancer

•Hyper progressive disease is a new form of progression in patients treated with immunotherapy.•The definition of HPD is yet to be consensual.•We suggest a clinical definition of patients refractory to immunotherapy based on the number of nivolumab injections.•20% of patients with advanced NSCLC pre...

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Bibliographic Details
Published in:Lung cancer (Amsterdam, Netherlands) Netherlands), 2019-04, Vol.130, p.128-134
Main Authors: Costantini, A., Fallet, V., Corny, J., Friard, S., Chouaid, C., Duchemann, B., Giroux-Leprieur, E., Taillade, L., Doucet, L., Brosseau, S., Wislez, M., Tredaniel, J., Cadranel, J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Immunological - therapeutic use
Cancer
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - mortality
Cohort Studies
Disease Progression
Drug Resistance, Neoplasm
Female
France
Humans
Life Sciences
Lung Neoplasms - drug therapy
Lung Neoplasms - mortality
Male
Middle Aged
Nivolumab
Nivolumab - therapeutic use
Non-small-cell lung cancer
Prospective Studies
Refractory
Survival Analysis
Treatment
Treatment Outcome
Young Adult
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Summary:•Hyper progressive disease is a new form of progression in patients treated with immunotherapy.•The definition of HPD is yet to be consensual.•We suggest a clinical definition of patients refractory to immunotherapy based on the number of nivolumab injections.•20% of patients with advanced NSCLC presented with nivolumab refractory disease in our real-life cohort.•Factors associated with refractory disease were PS ≥ 2, shorter duration of treatment before nivolumab initiation. : Immune checkpoint inhibitors (ICIs) have revolutionised cancer care especially in lung cancer. New response patterns have been described under ICIs such as pseudo-progression or hyper-progressive disease (HPD). The definition of HPD is yet to be consensual. The aim of this study was to suggest a clinical definition of nivolumab-refractory patients and find factors associated with this entity. : We performed a multi centric retrospective study including all patients who received nivolumab for the treatment of advanced non-small cell lung cancer (NSCLC) during the French authorisation for temporary use in 2015. : 303 patients were included in the cohort and 292 had details on the number of nivolumab injections received. 57 patients (20%) were nivolumab-refractory. These patients had worse PS at nivolumab initiation (p 
ISSN:0169-5002
1872-8332
DOI:10.1016/j.lungcan.2019.01.015