Published online Sep 24, 2022. doi: 10.5306/wjco.v13.i9.729
Peer-review started: March 28, 2022
First decision: June 22, 2022
Revised: June 26, 2022
Accepted: September 7, 2022
Article in press: September 7, 2022
Published online: September 24, 2022
Immunotherapy has shown great promise in treating various types of malignant tumors. However, some patients with gastrointestinal cancer have been known to experience rapid disease progression after treatment, a situation referred to as hyperprogressive disease (HPD). This minireview focuses on the definitions and potential mechanisms of HPD, natural disease progression in gastrointestinal malignancies, and tumor immunological microenvironment.
Core Tip: There have been several literature reviews on the definition, incidence, predictors, potential biomarkers, and prognosis of hyperprogressive disease. However, this is a minireview of two conflicting concepts: HPD is a new form of immunological response vs a natural process of advanced tumor progression. It also takes a look at cellular and molecular mechanisms of the pathways of the tumor microenvironment and recent clinical trials exploring the risk factors and mechanisms of HPD in gastrointestinal cancer.