2024 World Conference on Lung Cancer (WCLC) - Posters-P4.14C.05 Incidence of Pseudoprogression and Hyperprogression in Patients with Pleural Mesothelioma Treated with Ipilimumab and Nivolumab

P4.14C.05 Incidence of Pseudoprogression and Hyperprogression in Patients with Pleural Mesothelioma Treated with Ipilimumab and Nivolumab

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The study investigates the phenomena of pseudoprogression (PP) and hyperprogression (HP) in patients with pleural mesothelioma treated with the immune checkpoint inhibitors (ICI) Ipilimumab and Nivolumab. These phenomena, observed in other cancers, involve an initial increase in tumor burden followed either by a regression (PP) or by a rapid progression (HP). This study is significant as it aims to quantify PP and HP in pleural mesothelioma, where such data has been lacking.<br /><br />Methodologically, the study involved 72 patients whose genomic DNA was assayed, and serial CT scans were performed to assess tumor progression. PP was defined as an increase in tumor size at the first post-treatment scan that regressed at subsequent scans, while HP was characterized by a marked increase or new lesion growth within 12 weeks post-treatment. Statistical analysis, including Fisher's exact test and Wilcoxon rank sum, was used to analyze the incidence and characteristics of these phenomena.<br /><br />Key findings include that 34% of the patients exhibited worsening disease at the initial CT scan, with 65% of these experiencing subsequent regression, giving an overall PP rate of 15%. Meanwhile, the incidence of HP was 11%. It was noted that PP was more prevalent in female patients, whereas HP was more common in PD-L1 negative patients, but this was not statistically significant due to the small sample size.<br /><br />The study emphasizes that patients showing suspicions of disease progression on initial scans might still benefit from continuing treatment with ICIs in the absence of severe clinical symptoms. This research contributes to understanding the treatment dynamics of pleural mesothelioma and suggests considerations for ongoing patient management strategies with ICIs.

Asset Subtitle

Owen Mitchell

Meta Tag

Speaker Owen Mitchell

Topic Mesothelioma, Thymoma & Other Thoracic Tumors

Keywords

pseudoprogression

hyperprogression

pleural mesothelioma

immune checkpoint inhibitors

Ipilimumab

Nivolumab

tumor progression

PD-L1 negative

CT scans

genomic DNA