ArticleCancer imaging : the official publication of the International Cancer Imaging Society2023
Patterns of pseudoprogression across different cancer entities treated with immune checkpoint inhibitors.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Optimizing the clinical assessment of pseudoprogression in patients with solid tumors treated with checkpoint inhibitors: a systematic literature review and meta-analysis of associated features.Cancer immunology, immunotherapy : CII · 2026Pooled it
- Efficacy and safety of PD-1 and PD-L1 inhibitors in advanced colorectal cancer: a meta-analysis of randomized controlled trials.BMC gastroenterology · 2024Pooled it
- Tumor flare-like response: A novel imaging phenomenon with predictive significance in triple negative breast cancer patients undergoing neoadjuvant immuno-chemotherapy.Breast (Edinburgh, Scotland) · 2026Trial
- The type II RAF inhibitor tovorafenib in relapsed/refractory pediatric low-grade glioma: the phase 2 FIREFLY-1 trial.Nature medicine · 2024Trial
- Imaging of mass-forming intrahepatic cholangiocarcinoma: from detection to personalized treatments.Abdominal radiology (New York) · 2026Review
- MRI-based radiomics with automated segmentation and manual refinement for predicting treatment response in unresectable hepatocellular carcinoma: a multicenter study.Abdominal radiology (New York) · 2026Observational
- [Abdominal immune-related adverse events : Abdominal focus].Radiologie (Heidelberg, Germany) · 2026Review
- The Role of 18F-FDG PET/CT in Monitoring Immunotherapy Response in Non-Small Cell Lung Cancer: Current Evidence and Challenges: A Narrative Review.Diagnostics (Basel, Switzerland) · 2025Review
- A case of cutaneous angiosarcoma with intradermal metastases responding to PD-1 inhibition-based immunotherapy.JAAD case reports · 2025Article
- Pseudoprogression of pleural effusion in lung cancer treated with immunotherapy: a case report.Translational lung cancer research · 2025Article
- Heterogeneity in response to neoadjuvant radiotherapy between soft tissue sarcoma histotypes: associations between radiology and pathology findings.European radiology · 2025Article
- Immune Checkpoint Inhibitors for Microsatellite Instability High Unresectable Obstructive Colon Cancer: A Report of Two Cases.Surgical case reports · 2025Article
- IsCancers · 2024Review
- [Advances in Pseudoprogression of Immune Checkpoint Inhibitors in Non-small Cell Lung Cancer].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2024Review
- Activity of pembrolizumab and lenvatinib in mismatch repair deficient (dMMR) endometrial cancer patients who have failed pembrolizumab monotherapy: A case series.Gynecologic oncology reports · 2023Article
- Article
- Case Report: Long-term metabolic response of metastatic uveal melanoma to pembrolizumab on FDG-PET/CT despite a serial pseudoprogressions phenomenon.Frontiers in immunology · 2023Article
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Authors and funding
18 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPseudoprogression (PsPD) is a rare response pattern to immune checkpoint inhibitor (ICI) therapy in oncology. This study aims to reveal imaging features of PsPD, and their association to other relevant findings.
methodsPatients with PsPD who had at least three consecutive cross-sectional imaging studies at our comprehensive cancer center were retrospectively analyzed. Treatment response was assessed according to immune Response Evaluation Criteria in Solid Tumors (iRECIST). PsPD was defined as the occurrence of immune unconfirmed progressive disease (iUPD) without follow-up confirmation. Target lesions (TL), non-target lesions (NTL), new lesions (NL) were analyzed over time. Tumor markers and immune-related adverse events (irAE) were correlated.
resultsThirty-two patients were included (mean age: 66.7 ± 13.6 years, 21.9% female) with mean baseline STL of 69.7 mm ± 55.6 mm. PsPD was observed in twenty-six patients (81.3%) at FU1, and no cases occurred after FU4. Patients with iUPD exhibited the following: TL increase in twelve patients, (37.5%), NTL increase in seven patients (21.9%), NL appearance in six patients (18.8%), and combinations thereof in four patients (12.5%). The mean and maximum increase for first iUPD in sum of TL was 19.8 and 96.8 mm (+ 700.8%). The mean and maximum decrease in sum of TL between iUPD and consecutive follow-up was - 19.1 mm and - 114.8 mm (-60.9%) respectively. The mean and maximum sum of new TL at first iUPD timepoint were 7.6 and 82.0 mm respectively. In two patients (10.5%), tumor-specific serologic markers were elevated at first iUPD, while the rest were stable or decreased among the other PsPD cases (89.5%). In fourteen patients (43.8%), irAE were observed.
conclusionsPsPD occurred most frequently at FU1 after initiation of ICI treatment. The two most prevalent reasons for PsPD were TL und NTL progression, with an increase in TL diameter commonly below + 100%. In few cases, PsPD was observed even if tumor markers were rising compared to baseline. Our findings also suggest a correlation between PsPD and irAE. These findings may guide decision-making of ICI continuation in suspected PsPD.
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