Research and progress of hyperprogression after immunotherapy

As a new milestone in cancer treatment, modern immunotherapy has brought subversive changes to many tumour treatments that lack effective treatment methods. In the past decade, given our knowledge and understanding of adaptive immunity at the molecular level, the development of immune checkpoint inhibitor drugs has been promoted. Immune checkpoint inhibitors such as pembrolizumab and nivolumab are a brand-new treatment model, which is different from traditional chemotherapy or targeted therapy of molecular-level precision therapy. In addition, the regulation of tumour immune microenvironment promotes autoimmune cells to exert powerful anti-tumour effects. It has shown excellent performance in many clinical trials and real-world studies. The significant evident survival benefits, lower incidence of treatment adverse reactions and improved quality of life of patients receiving treatment have indicated its importance in the treatment of many advanced solid tumours. It brings new hope for the treatment of various types of solid tumours, and is a new boon for many patients with advanced tumours. However, with the popularity of its use, some clinicians have found that instead of significant survival benefit in immunotherapy, some patients experienced rapid tumour progression and even rapid death in a short period of time. This phenomenon is known as immunotherapy hyperprogression. At present, the research on the mechanism of hyperprogression and clinical strategies is quite limited. This article aims to review the definition, clinical features, mechanism of occurrence, differential diagnosis and patient management to identify the hyperprogression phenomena as early as possible during treatment and take timely measures to improve the prognosis of patients with advanced cancer and bring survival benefits.