Abstract
Gastrointestinal cancers are very common cancers with colorectal being the fourth most common type, gastric the sixth, and esophageal the tenth. Although recent advances have been made in management including incorporation of antiangiogenic, anti-EGFR, and anti-HER2 directed therapies, overall their prognosis remains poor. Anti-PD-1 therapy with nivolumab and pembrolizumab are licensed for advanced chemorefractory gastroesophageal cancer and many other checkpoint inhibitor therapies are being assessed alone and in combination in these diseases. One of the challenges posed in assessing response to immunotherapy treatment is the phenomenon of pseudoprogression. This phenomenon, which is well described in patients with malignant melanoma is most frequently described as a size increase of contrast enhancing lesions or appearance of new lesions that stabilize or reduce in size with time. Most other solid tumors have a low incidence of pseudoprogression although cases have been reported for lung, head, and neck cancer and a range of gliomas. Herein we present 6 cases of patients with gastrointestinal cancers who were treated with anti-PD1 (programmed cell death) and anti-PD-L1 (programmed cell death ligand-1) antibodies, and experience pseudoprogression.
Copyright © 2019 Elsevier Inc. All rights reserved.
Publication types
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Adult
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Antibodies, Monoclonal, Humanized / pharmacology
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Antibodies, Monoclonal, Humanized / therapeutic use
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Antineoplastic Agents, Immunological / pharmacology
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Antineoplastic Agents, Immunological / therapeutic use*
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Antineoplastic Combined Chemotherapy Protocols / pharmacology
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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B7-H1 Antigen / antagonists & inhibitors
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B7-H1 Antigen / immunology
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Contrast Media / administration & dosage
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Disease Progression
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Drug Resistance, Neoplasm
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Female
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Gastrointestinal Neoplasms / diagnostic imaging
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Gastrointestinal Neoplasms / drug therapy*
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Gastrointestinal Neoplasms / immunology
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Gastrointestinal Neoplasms / pathology
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Humans
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Male
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Melanoma / diagnostic imaging
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Melanoma / drug therapy
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Melanoma / immunology
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Melanoma / pathology
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Middle Aged
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Nivolumab / pharmacology
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Nivolumab / therapeutic use
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Programmed Cell Death 1 Receptor / antagonists & inhibitors
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Programmed Cell Death 1 Receptor / immunology
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Protein Kinase Inhibitors / pharmacology
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Protein Kinase Inhibitors / therapeutic use
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Skin Neoplasms / diagnostic imaging
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Skin Neoplasms / drug therapy
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Skin Neoplasms / immunology
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Skin Neoplasms / pathology
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Tomography, X-Ray Computed
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Treatment Outcome
Substances
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents, Immunological
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B7-H1 Antigen
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CD274 protein, human
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Contrast Media
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PDCD1 protein, human
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Programmed Cell Death 1 Receptor
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Protein Kinase Inhibitors
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Nivolumab
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pembrolizumab