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- Title
Mechanistic insights into lethal hyper progressive disease induced by PD-L1 inhibitor in metastatic urothelial carcinoma.
- Authors
Nishimura, Kazuki; Takahara, Kiyoshi; Komura, Kazumasa; Ishida, Mitsuaki; Hirosuna, Kensuke; Maenosono, Ryoichi; Ajiro, Masahiko; Sakamoto, Moritoshi; Iwatsuki, Kengo; Nakajima, Yuki; Tsujino, Takuya; Taniguchi, Kohei; Tanaka, Tomohito; Inamoto, Teruo; Hirose, Yoshinobu; Ono, Fumihito; Kondo, Yoichi; Yoshimi, Akihide; Azuma, Haruhito
- Abstract
Hyper progressive disease (HPD) is a paradoxical phenomenon characterized by accelerated tumor growth following treatment with immune checkpoint inhibitors. However, the pathogenic causality and its predictor remain unknown. We herein report a fatal case of HPD in a 50-year-old man with metastatic bladder cancer. He had achieved a complete response (CR) through chemoradiation therapy followed by twelve cycles of chemotherapy, maintaining CR for 24 months. Three weeks after initiating maintenance use of a PD-L1 inhibitor, avelumab, a massive amount of metastases developed, leading to the patient's demise. Omics analysis, utilizing metastatic tissues obtained from an immediate autopsy, implied the contribution of M2 macrophages, TGF-β signaling, and interleukin-8 to HPD pathogenesis.
- Publication
NPJ Precision Oncology, 2024, Vol 8, Issue 1, p1
- ISSN
2397-768X
- Publication type
Article
- DOI
10.1038/s41698-024-00707-6