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Lung Cancer May Grow Faster During Immunotherapy

(Medscape Medical News) Nov 13, 2017 - A retrospective analysis from France found that 14% of patients with advanced lung cancer showed an acceleration of tumor growth while receiving immunotherapy.

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H. Jack West, MD (Posted: November 14, 2017)

quotesThis is interesting and somewhat helpful for turning a clinical observation at the anecdotal level into retrospective data that actually characterize the frequency of this issue in a clinical population. However, we also need to ask what we do with this information. The report indicates that hyper-progression is seen a little more commonly with immunotherapy than with chemo in advanced NSCLC. However, we can't reliably predict who will demonstrate hyper-progression. The authors find that patients with a higher number of metastatic sites have higher risk, but the absolute difference isn't enough to make this a clinically helpful predictor. Given the clear survival benefit with several immune checkpoint inhibitors over chemo in previously treated NSCLC, this information doesn't/shouldn't dissuade an oncologist from favoring a checkpoint inhibitor based on the far more clear prospective clinical trial data. That said, it's a valuable starting point for further study of this issue.quotes

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