恶性肿瘤行免疫检查点抑制剂治疗中出现超进展性疾病的研究进展

Research progress of hyperprogressive disease in malignant tumors treated with immune checkpoint inhibitors therapy

目的总结超进展性疾病(hyperprogressive disease,HPD)的定义、发生率、危险因素、潜在发病机制、生物标志物、后续治疗策略的选择等。方法通过查阅并筛选国内外相关文献,归纳总结恶性肿瘤患者行免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)治疗中出现HPD的研究进展。结果HPD的研究类型分散,样本数量有限,界定标准不一,缺乏前瞻性验证研究,HPD发生的预警评估和分子机制将成为免疫治疗下一步研究的重点。结论ICIs极大地改善了部分晚期恶性肿瘤患者的生存期,虽然部分患者在治疗过程中发生了HPD,但发生率相对较低。

Objective To review the definition,incidence,risk factors,potential pathogenesis,biomarkers,and choice of follow-up treatment strategies of hyperprogressive disease(HPD).Method Domestic and international literatures were collected to summarize the research progress of HPD in patients with malignant tumors who treated with immune checkpoint inhibitors(ICIs).Results The research types of HPD were scattered,the sample size was limited,the definition standard was different,and there was lack of prospective validation studies.Therefore,the early warning assessment and molecular mechanism of HPD would become the next focus of the study of immunotherapy.Conclusion ICIs can greatly improve the survival time of some patients with advanced malignant tumor,although some patients have HPD during treatment,but the incidence is relatively low.