Hyperprogressive disease during nivolumab chemotherapy in metastatic gastric cancer: Multicenter retrospective study in Japan.

Authors

null

Takeshi Suzuki

Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

Takeshi Suzuki , Masahiko Aoki , Hiromichi Shirasu , Naoki Takahashi , Rie Nakatsuka , Takayuki Ando , Yosuke Kito , Yoshiyuki Yamamoto , Kentaro Kawakami , Toshihiko Matsumoto , Keitaro Shimozaki , Michitaka Nagase , Toshifumi Yamaguchi , Yuji Negoro , Takao Tamura , Yusuke Amanuma , Taito Esaki , Yuji Miura , Kengo Nagashima , Narikazu Boku

Organizations

Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan, National Cancer Center Hospital, Tokyo, Japan, Division of Clinical Oncology, Shizuoka Cancer Center, Shizuoka, Japan, Saitama Cancer Center, Saitama, Japan, Department of Surgery, Osaka General Medical Center, Osaka, Japan, Third Department of Internal Medicine, University of Toyama, Toyama, Japan, Department of Medical Oncology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan, University of Tsukuba, Tsukuba, Japan, Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, Japan, Himeji Red Cross Hospital, Himeji, Japan, Keio University, Tokyo, Japan, Department of Clinical Oncology, Jichi Medical University, Shimotsuke, Japan, Department of Cancer Chemotherapy Center, Osaka Medical Collage Hospital, Osaka, Japan, Department of Gastroenterology, Kochi Health Sciences Center, Kochi, Japan, Department of Medical Oncology, Kindai University Nara Hospital, Ikoma, Japan, Clinical Trial Promotion Department, Chiba Cancer Center, Chiba, Japan, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan, Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan, Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo, Japan

Research Funding

No funding received
None

Background: Nivolumab has demonstrated a survival benefit for advanced gastric cancer (AGC). However, hyperprogressive disease (HPD) has been reported in various cancers. Methods: The subjects of this retrospective study were AGC patients with measurable disease who received nivolumab, and their tumors were assessed at least 3 times (during prior therapy, before and after nivolumab) in 24 institutions. Tumor growth rates (TGR) during nivolumab were compared to those during prior therapy as reported (Champiat S, 2017). HPD was defined as an increase in TGR > 2-fold. Results: 218 patients were identified as the subjects. While 33 (15.1%) partial response (PR) were achieved, 130 patients (59.6%) showed progression disease (PD), 38 of whom were classified as HPD (17.4%) and 2 patients showed pseudo progression (1.0%). The median progression-free survival (PFS) was 1.9 months (95% CI: 1.9–2.4) and the median overall survival (OS) was 8.5 months (95% CI: 7.1–9.6) in all patients. While patients with PD showed shorter prognosis compared with non-PD patients (median PFS: 1.5 months vs 6.4 months, hazard ratio; 6.0 [95% CI: 4.3–8.4]; p < 0.0001; median OS: 4.7 months vs not reached, hazard ratio; 4.1 [95% CI: 2.8–6.3]; p < 0.0001), there were no differences either in PFS or OS between patients with HPD and those with PD other than HPD (median PFS: 1.5 months vs 1.6 months, hazard ratio; 1.3 [95% CI: 0.9–2.0]; p = 0.1194; median OS: 5.0 months vs 4.6 months, hazard ratio; 1.0 [95% CI: 0.6–1.5]; p = 0.8695). Histological type, liver metastases, carbohydrate antigen 19-9 (CA19-9) level were associated with HPD. Conclusions: HPD was observed 17.4% in AGC patients treated with nivolumab. There were no differences either in PFS or OS between patients with HPD and those with PD other than HPD. Clinicopathological characteristics might be a predict factor for HPD.

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Abstract Details

Meeting

2020 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Esophageal and Gastric Cancer and Other GI Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Therapeutics

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr 377)

Abstract #

377

Poster Bd #

E10

Abstract Disclosures