Background: Hyperprogressive disease (HPD), characterised by a rapid increase in tumour growth rate, has been recently reported in patients (pts) treated (tx) with CPI monotherapy and requires evaluation of pre-tx tumour growth rates. HPD is rare and has been associated with older age (>65 y; Champiat, CCR 2017), EGFR mutation (Kurzrock, Kato 2018) and poor OS. In the Phase III OAK study in 2L/3L NSCLC (n = 850), ITT OS was superior for atezo vs doc (mOS, 13.8 vs 9.6 mo; HR, 0.73). Here we examine fast progression (FP) as a surrogate for HPD, its relation to CPI vs chemo and association with efficacy according to pre-tx factors expected to be prognostic for FP, including early failure of the preceding tx.
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Gandara et al. (2018) studied this question.