Introduction: A new pattern of response, so-called hyper-progressive disease (HPD), is emerging during treatment with immune checkpoint inhibitors (ICI). Our aim was to investigate the prevalence of such phenomenon and to assess its association with clinical variables and metabolic parameters by ¹⁸F-fludeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT). Methods: Data from 50 patients (34 male, 16 female, median age 73) with non-small cell lung carcinoma (NSCLC) and treated with ICI were prospectively collected. All patients underwent contrast-enhanced CT, ¹⁸F-FDG PET/CT, and complete peripheral blood sample at baseline before ICI. HPD was defined according to clinical and radiologic criteria. Because of the rapid disease progression or worsening of clinic conditions, radiologic response assessment was available for 46 patients. OS were analyzed using the Kaplan–Meier method and the log-rank test. A Cox proportional hazards regression analysis was used to evaluate factors independently associated with OS. Median follow-up was 12.4 months (9.7-15.2 months). Results: We identified the following response categories: 10 cases as complete/partial response (CR/PR), 17 cases with stable disease (SD), 5 patients with progressive disease (PD), and 14 with HPD. Among metabolic parameters we observed a statistically significant association between HPD status and tumor burden, expressed by both MTV (756.1ml for HPD vs 475.6ml for non-HPD, P = 0.011) and TLG (287.3 for HPD vs 62.1 for non-HPD, P = 0.042). Among clinical variables, 12/14 patients (85.7%) within the HPD group compared with 8/32 patients (25%) in the non-HDP group had more than two metastatic sites (p<0.001). In addition, the derived neutrophil-to-lymphocyte ratio (dNLR) and platelet counts was significantly associated with HPD status (P = 0.038, P = 0.025, respectively). Survival analysis showed a median OS of 4 months for HPD group compared with 15 months within non-HPD patients (P = 0.003). Likewise, median OS was significantly different when we considered all the response categories: CR/PR, SD, PD, and HPD (P = 0.001). Finally, Multivariate analysis identified MTV and dNLR as independent predictors for OS. Conclusion: Our results suggest that the use of ICI might represent a concern in patients with high metabolic tumor burden and inflammatory indexes at baseline. However Additional studies are needed.

Immune checkpoint blockade represents a promising approach in oncology, showing anti-tumor activities in various cancers. However, although being generally far more well-tolerated than classical cytotoxic chemotherapy, this treatment, too, may be accompanied by considerable side effects and not all patients benefit equally. Therefore, careful patient selection and monitoring of the treatment response is mandatory. At present, checkpoint-specific molecular imaging is increasingly investigated as a tool for patient selection and response evaluation. Here, an overview of the current developments in immune checkpoint imaging is provided.

South Dakota Gov. Kristi Noem has ordered two Sioux tribes to remove checkpoints designed to curb the coronavirus on tribal lands.

Green Lake’s mayor says he wants to see further measures introduced to prevent people who aren't from Saskatchewan from travelling through his community as the region deals with the COVID-19 pandemic. 

Statewide Enforcement Checkpoints Aim to Reduce DUI-Related Crashes & Fatalities  (Dover, DE) – On Thursday, June 13th, Attorney General Kathy Jennings swore in 53 officers representing jurisdictions from New Castle, Kent, and Sussex Counties to serve as part of the Checkpoint StrikeForce (CPSF) and other checkpoints that will take place throughout the state this year. Impaired […]

FOR IMMEDIATE RELEASE Media Contacts: Cynthia Cavett, Marketing Specialist & Public Information Officer Delaware Office of Highway Safety Cynthia.Cavett@delaware.gov 302-744-2743 The Delaware Office of Highway Safety is activating Checkpoint StrikeForce across the state on Friday, July 12th into Saturday morning, July 13th Dover, DE (July 12, 2019) – While the summer continues to heat up, […]

FOR IMMEDIATE RELEASE July 19, 2019 Cynthia Cavett, Marketing Specialist II and Public Information Officer (OHS) Cynthia.Cavett@Delaware.Gov Results of July 12th Impaired Driving Checkpoints Over 60 Law Enforcement Officers operated July Checkpoint StrikeForce    Dover, DE (July 19, 2019) – Three DUI checkpoints in all three counties were set up on July 12, 2019, from […]

OHS Activates Operation Checkpoint StrikeForce For All 3 counties This Weekend Dover, Del. (October 25, 2019) – The Delaware Office of Highway Safety is coordinating Operation Checkpoint Strikeforce in each county statewide for Halloween weekend. This zero-tolerance initiative in Delaware, implemented since 2002, is designed to get impaired drivers off of our roads using checkpoints and patrols. The […]

(Dover, Del.) October 28, 2019 – The Delaware Office of Highway Safety (OHS) coordinated DUI checkpoints in all three counties on Saturday, October, 26th, from 10 p.m. until Sunday, October 27th, at 2 a.m. the following morning. Working together with the Delaware State Police and local law enforcement, OHS supported three DUI checkpoints across the state. OHS is pleased to […]

The statewide Thanksgiving 2019 DUI Checkpoint was a success Dover, Del. (December 2, 2019) – The Delaware Office of Highway Safety (OHS) coordinated DUI checkpoints on Thanksgiving Eve in each county statewide on November 27, from 10 PM to November 28, at 2 AM the following morning. Checkpoint Results Working together with the Delaware State […]

Operation Checkpoint StrikeForce Activated this weekend in conjunction with the Safe Family Holiday DUI Enforcement Campaign FOR IMMEDIATE RELEASE Media Contacts: Cynthia Cavett, Marketing Specialist II & Public Information Officer Delaware Office of Highway Safety Cynthia.Cavett@delaware.gov 302-744-2740 Dover, Del. (December 13, 2019) – The Delaware Office of Highway Safety is coordinating Operation Checkpoint Strikeforce in […]

Three drivers arrested for driving while impaired and nine individuals arrested on drug-related charges FOR IMMEDIATE RELEASE Media Contact: Cynthia Cavett, Marketing Specialist II & Public Information Officer Delaware Office of Highway Safety Cynthia.Cavett@delaware.gov 302-744-2740 Dover, Del. (December 16, 2019) – The Delaware Office of Highway Safety coordinated DUI checkpoints in each county statewide this past weekend […]

South Dakota Gov. Kristi Noem (R) “has given an ultimatum to...

The impact on survival of steroids and TNFα blockade to treat immune-related toxicity from checkpoint blockade with ipilimumab, nivolumab/pembrolizumab, or combined ipilimumab and nivolumab was assessed using data from a large national database. Using steroids was associated with better survival than the use of TNFα-blocking antibodies such as infliximab.

See related article by Verheijden et al., p. 2268

A multi-year collaboration between China’s Innovent Biologics and USA-based Eli Lilly is bearing fruit,…

A new mathematical model to predict the response of HIV-infected individuals to a type of cancer immunotherapy has been developed by scientists led by Andreas Meyerhans and Gennady Bocharov.

Hayden Library - PQ2678.U357 C4413 2017

Interview with David J. Pinato, MD, author of Association of Prior Antibiotic Treatment With Survival and Response to Immune Checkpoint Inhibitor Therapy in Patients With Cancer

Interview with Charles Dolladille, MD, author of Immune Checkpoint Inhibitor Rechallenge After Immune-Related Adverse Events in Patients With Cancer

After being injected into tumors, the bacteria self-destruct to release their therapeutic cargo

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