ArticleClinical and experimental immunology2020
Sarcopenia and high NLR are associated with the development of hyperprogressive disease after second-line pembrolizumab in patients with non-small-cell lung cancer.
Article in Clinical and experimental immunology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
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27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Associations between inflammatory biomarkers, symptoms, treatment toxicities and quality of life in people with advanced cancer receiving systemic anti-cancer treatments: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- Sex and risk of hyperprogressive disease in cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Neutrophil-to-lymphocyte ratio as a predictive biomarker for hyperprogressive disease mediated by immune checkpoint inhibitors: a systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Hyperprogressive disease in patients suffering from solid malignancies treated by immune checkpoint inhibitors: A systematic review and meta-analysis.Frontiers in oncology · 2022Pooled it
- Association of Skeletal Muscle Radiodensity and Skeletal Muscle Index with Immunotherapy Response in Metastatic Non-Small Cell Lung Cancer.Muscles (Basel, Switzerland) · 2025Article
- Evaluation of the utility of different laboratory test-related sarcopenia indices as predictors of lung cancer mortality.BMC geriatrics · 2025Article
- Impact of skeletal muscle loss and sarcopenia on outcomes of neoadjuvant immunochemotherapy in esophageal squamous cell carcinoma.Frontiers in nutrition · 2025Article
- Prognostic value of immunotherapy in advanced NSCLC based on baseline and dynamic changes in HALP.Biomolecules & biomedicine · 2024Article
- Influence of cachexia on immunotherapy efficacy and prognosis for malignant tumors of the digestive system.Cancer reports (Hoboken, N.J.) · 2024Article
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- Hyperprogressive disease in lung metastases without target lesion progression after durvalumab consolidation therapy: A case report.Thoracic cancer · 2023Article
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- Prognostic value of inflammatory and nutritional indexes among advanced NSCLC patients receiving PD-1 inhibitor therapy.Clinical and experimental pharmacology & physiology · 2023Article
- Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma in Older Patients: Are New Agents Bringing New Hope?Drugs & aging · 2023Review
- Correlation of preclinical and clinical biomarkers with efficacy and toxicity of cancer immunotherapy.Therapeutic advances in medical oncology · 2023Review
- Radiomics-guided checkpoint inhibitor immunotherapy for precision medicine in cancer: A review for clinicians.Frontiers in immunology · 2023Review
- A Novel Neutrophil-to-Lymphocyte Ratio and Sarcopenia Based TACE-Predict Model of Hepatocellular Carcinoma Patients.Journal of hepatocellular carcinoma · 2023Article
- Hyperprogressive disease in non-small cell lung cancer after PD-1/PD-L1 inhibitors immunotherapy: underlying killer.Frontiers in immunology · 2023Review
- Blood Based Biomarkers as Predictive Factors for Hyperprogressive Disease.Journal of clinical medicine · 2022Article
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Authors and funding
18 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this multi-center retrospective study was to evaluate the incidence of hyperprogressive disease (HPD) after second-line treatment with pembrolizumab in patients (n = 167) with metastatic non-small-cell lung cancer (NSCLC) whose tumors expressed programmed cell death ligand 1 (PD-L1) in ≥ 1% and to search for hematological and imaging biomarkers associated with its development. Prior to chemotherapy, neutrophil : lymphocyte ratio (NLR1) and platelet : lymphocyte ratio (PLR1), and prior to immunotherapy, NLR2 and PLR2 were retrospectively analyzed. The psoas major muscle area (PMMA) was calculated at the L3 position on computed tomography before chemotherapy (PMMA1) and before immunotherapy (PMMA2) (n = 112). Patients with ∆PMMA (1-PMMA2/PMMA1) × 100 ≥ 10% were considered to have sarcopenia (low muscle mass). After treatment with pembrolizumab on the first computerized tomography (CT) scan evaluation, patients were subdivided as follows as: hyperprogressors (HPs), progressors (Ps), non-progressors (NPs) and pseudoprogressors (PPs). HPs had significantly higher ∆PMMA levels, NLR2 and PLR2 than the other patients. Moreover, in multinomial logistic regression analysis, higher levels of ∆PMMA were associated with a decreased likelihood of being a P [odds ratio (OR) = 0·81; 95% confidence interval (CI) = 0·65-0·99; P = 0·047] or an NP (OR = 0·76; 95% CI = 0·62-0·94; P = 0·012) versus an HP. Higher NLRs tended to decrease the likelihood of being a P versus an HP (OR = 0·66; 95% CI = 0·42-1·06; P = 0·09) and significantly decreased the likelihood of being an NP versus an HP (OR = 0·44; 95% CI = 0·28-0·69; P < 0·0001). Our data suggest that a high pre-immunotherapy NLR2 and the presence of sarcopenia are potential risk factors for the development of HPD.
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