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- W2912703111 abstract "124 Background: Nivolumab has demonstrated a survival benefit as a single agent in patients with advanced gastric cancer (AGC) refractory to, or intolerant of, two or more previous regimens in phase III study (ATTRACTION-2). However, an acceleration of tumor growth during immunotherapy, (hyperprogressive disease: HPD), was reported in advanced cancers treated with immunotherapy. The frequency and outcome of HPD in AGC comparing between immunotherapy and cytotoxic agents are little known. The aim of this study was to clarify the prevalence and background of HPD in patients treated with nivolumab or irinotecan. Methods: The subjects of this retrospective study were AGC patients with measurable disease defined by RECIST version 1.1 who were treated with nivolumab or irinotecan at our institution between June 2009 and September 2018, and whose tumors were assessed at least 3 times (during prior therapy, immediately before and after initiating nivolumab or irinotecan). The tumor growth rates (TGR) both before and after nivolumab or irinotecan were calculated as reported (Stéphane Champiat, Clin Cancer Res 2017). HPD was defined as an increase in the TGR exceeding 50% after nivolumab or irinotecan compared with prior therapy. Results: 32 and 66 patients received nivolumab and irinotecan (20 patients received both irinotecan and nivolumab). There were more prior chemotherapy before nivolumab than irinotecan (median: 3 vs 2). The median overall survival (MST) was 4.1 months (95%CI; 4.6-9.3 months) after nivolumab, and 7.0 months (95%CI; 6.3-9.3 months) after irinotecan. There were 9 patients showing HPD (28.1%) after initiating nivolumab and 9 patients (13.5%) after irinotecan (p = 0.0824). There were no differences in background between patients with and without HPD either after nivolumab or irinotecan. 9 patients with HPD showed shorter survival than those without HPD after nivolumab (median: 1.9 vs 6.4 months, p = 0.0007) while there was no such difference after irinotecan (median: 7.3 vs 7.0 months, p = 0.3345). Conclusions: HPD was observed more frequently after initiating nivolumab compared with irinotecan, and was associated with a poor prognosis after nivolumab but not after irinotecan." @default.
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- W2912703111 date "2019-02-01" @default.
- W2912703111 modified "2023-10-12" @default.
- W2912703111 title "The hyperprogressive disease during nivolumab treatment or irinotecan treatment in patients with advanced gastric cancer." @default.
- W2912703111 doi "https://doi.org/10.1200/jco.2019.37.4_suppl.124" @default.
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