Minireviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Sep 24, 2022; 13(9): 729-737
Published online Sep 24, 2022. doi: 10.5306/wjco.v13.i9.729
Hyperprogression under treatment with immune-checkpoint inhibitors in patients with gastrointestinal cancer: A natural process of advanced tumor progression?
Mo-Xuan Wang, Shu-Yue Gao, Fan Yang, Run-Jia Fan, Qin-Na Yang, Tian-Lan Zhang, Nian-Song Qian, Guang-Hai Dai
Mo-Xuan Wang, Shu-Yue Gao, Fan Yang, Run-Jia Fan, Qin-Na Yang, Tian-Lan Zhang, Department of Oncology, Chinese PLA Medical School, Beijing 100853, China
Nian-Song Qian, Department of Oncology, Senior Department of Respiratory and Critical Care Medicine, The Eighth Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Guang-Hai Dai, Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Wang MX and Gao SY wrote the article and contributed equally to this article; Yang F performed data accusation; Fan RJ provided input in writing the paper; Yang QN prepared the references; Zhang TL participated in maintaining the integrity of the data; Qian NS designed the outline and coordinated the writing of the paper; Dai QH critically reviewed the manuscript.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nian-Song Qian, PhD, Associate Professor, Department of Oncology, Senior Department of Respiratory and Critical Care Medicine, The Eighth Medical Center of Chinese PLA General Hospital, No.17 A Heishanhu Road, Haidian District, Beijing 100853, China. kyotomed@foxmail.com
Received: March 28, 2022
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
Abstract

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.

Keywords: Hyperprogressive, Immunotherapy, Natural process, Gastric cancer, Colorectal cancer

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.