Evidence map›Paper›PMID 36905578›Full record

Trial reportThe oncologist2023

Low Risk of Hyperprogression with First-Line Chemoimmunotherapy for Advanced Non-Small Cell Lung Cancer: Pooled Analysis of 7 Clinical Trials.

Lee X Li, Federico Cappuzzo, Ignacio Matos, Mark A Socinski, Ashley M Hopkins, Michael J Sorich

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in The oncologist, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Early Hyperprogression of Rhabdomyosarcoma Detected byWorld journal of nuclear medicine · 2024
    Article
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 5 countries.

Lee X LiDepartment of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia.ORCID 0000-0001-5259-5198
Federico CappuzzoOncology Department, Istituto Nazionale Tumori IRCCS "Regina Elena", Rome, Italy.ORCID 0000-0002-6295-6767
Ignacio MatosDepartment of Oncology, Clinica Universidad de Navarra, Madrid, Spain.ORCID 0000-0002-6396-630X
Mark A SocinskiThoracic Oncology, AdventHealth Cancer Institute, Orlando, FL, USA.ORCID 0000-0003-2915-9325
Ashley M HopkinsDepartment of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
Michael J SorichDepartment of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia.ORCID 0000-0003-1999-866X
Flinders University · AUFlorida Hospital Cancer Institute · USIstituti di Ricovero e Cura a Carattere Scientifico · ITLondon Cancer · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMonotherapy immune checkpoint inhibitor (ICI) used in second- or later-line settings has been reported to induce hyperprogression. This study evaluated hyperprogression risk with ICI (atezolizumab) in the first-, second-, or later-line treatment of advanced non-small cell lung cancer (NSCLC), and provides insights into hyperprogression risk with contemporary first-line ICI treatment.

methodsHyperprogression was identified using Response Evaluation Criteria in Solid Tumours (RECIST)-based criteria in a dataset of pooled individual-participant level data from BIRCH, FIR, IMpower130, IMpower131, IMpower150, OAK, and POPLAR trials. Odds ratios were computed to compare hyperprogression risks between groups. Landmark Cox proportional-hazard regression was used to evaluate the association between hyperprogression and progression-free survival/overall survival. Secondarily, putative risk factors for hyperprogression among second- or later-line atezolizumab-treated patients were evaluated using univariate logistic regression models.

resultsOf the included 4644 patients, 119 of the atezolizumab-treated patients (n = 3129) experienced hyperprogression. Hyperprogression risk was markedly lower with first-line atezolizumab-either chemoimmunotherapy or monotherapy-compared to second/later-line atezolizumab monotherapy (0.7% vs. 8.8%, OR = 0.07, 95% CI, 0.04-0.13). Further, there was no statistically significant difference in hyperprogression risk with first-line atezolizumab-chemoimmunotherapy versus chemotherapy alone (0.6% vs. 1.0%, OR = 0.55, 95% CI, 0.22-1.36). Sensitivity analyses using an extended RECIST-based criteria including early death supported these findings. Hyperprogression was associated with worsened overall survival (HR = 3.4, 95% CI, 2.7-4.2, P < .001); elevated neutrophil-to-lymphocyte ratio was the strongest risk factor for hyperprogression (C-statistic = 0.62, P < .001).

conclusionsThis study presents first evidence for a markedly lower hyperprogression risk in advanced NSCLC patients treated with first-line ICI, particularly with chemoimmunotherapy, as compared to second- or later-line ICI treatment.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsDisease ProgressionHumansImmune Checkpoint InhibitorsProgression-Free SurvivalImmune Checkpoint Inhibitorschemoimmunotherapyhyperprogressionhyperprogressive diseaseimmune checkpoint inhibitornon–small cell lung cancer

Identifiers

PMID36905578
PMCPMC10078909
OpenAlexW4323921009

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.