The potential mechanism, recognition and clinical significance of tumor pseudoprogression after immunotherapy

Wenxiao Jia, Qianqian Gao, Anqin Han, et al

Abstract


As immunotherapy has gained increasing interest as a new foundation for cancer therapy, some atypical response patterns, such aspseudoprogression and hyperprogression, have garnered the attention of physicians. Pseudoprogression is a phenomenon inwhich an initial increase in tumor size is observed or new lesions appear, followed by a decrease in tumor burden; thisphenomenon can benefit patients receiving immunotherapy but often leads to premature discontinuation of treatment owing tothe false judgment of progression. Accurately recognizing pseudoprogression is also a challenge for physicians. Because of theextensive attention on pseudoprogression, significant progress has been made. Some new criteria for immunotherapy, such asirRC, iRECIST and imRECIST, were proposed to accurately evaluate the response to immunotherapy. Many new detectionindexes, such as ctDNA and IL-8, have also been used to identify pseudoprogression. In this review, the definition, evaluationcriteria, mechanism, monitoring, management and prognosis of pseudoprogression are summarized, and diagnostic andtreatment processes for patients with progression but with a suspicion of pseudoprogression are proposed; these processes couldbe helpful for physicians in clinical practice and enhances the understanding of pseudoprogression.

Cite this article as: Jia W, Gao Q, Han A, Zhu H, Yu J. The potentialmechanism, recognition and clinical significance of tumor pseudoprogressionafter immunotherapy. Cancer Biol Med. 2019; 16: 655-70. doi:10.20892/j.issn.2095-3941.2019.0144


Keywords


Cancer; immunotherapy; pseudoprogression; RECIST; ctDNA; IL-8

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