New Biological Insights and Recent Therapeutic Advances in the Management of Lung Cancer: A Clinical Investigator Think Tank
Pseudoprogression with anti-PD-1/PD-L1 antibodies
1:37 minutes.
TRANSCRIPTION:
DR KRIS: I think if, when you look at the spider plots, it’s pretty rare. And the key there, actually, this is a point today. You’ve got to be a doctor. It’s all about talking to the patient and seeing what that drug is doing for them. And in some ways, whatever happens on the scan is irrelevant. And that actual phenomenon where there’s a PR or, I’m sorry, documented progression, is really rare. DR LANGER: I agree. It’s quite rare, but in another era we would have taken that patient off treatment or clinical trial prematurely. DR KRIS: I sure hope not. DR LANGER: In another era with cytotoxics, absolutely. DR KRIS: If they had POD? That’s very rare. DR LANGER: Progression of disease, we would have stopped the treatment. DR KRIS: Yes, but it’s very rare you see it. DR OXNARD: Other patients have very real progression. And we don’t want clinicians to keep giving the drug when they’re actively — DR KRIS: Pseudoprogression, we call it. DR SPIGEL: That’s a fantastic point. I mean, that is not hard to figure out, I mean, scans, but clinically you know that pretty quickly. I will say one thing. Corey alluded to this. We have a handful of people who came off for true progression, clinical and radiographic, who either were referred to hospice or another option and decided not to do anything and kind of disappeared. And we followed up with them. We have one young woman who’s now 7 months out, and we imaged her. And there’s no cancer in her body. And that wasn’t the case when we took her off the study, months ago. DR LOVE: Yes, I’ve heard of these stories about people responding while they’re in hospice and then coming out of hospice with these delayed responses. |