A subset of patients receiving modern cancer immunotherapy such as checkpoint inhibitors may show progression of the tumor rather than its disappearance.
Patient selection: malignant tumor being treated with immunotherapy
Clinical features:
(1) rapid tumor growth after initiation of immunotherapy
(2) possible reduction in tumor growth with discontinuation of immunotherapy
(3) worse survival
Objective definitions of tumor growth vary and may involve:
(1) change in tumor size/volume/burden
(2) accelerated tumor growth kinetics (TGK)
(3) increased tumor growth rate (TGR)
(4) reduced time to treatment failure
Differential diagnosis:
(1) pseudoprogression
(2) another explanation for rapid tumor growth, such as dedifferentiation or undergradiing
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