Publication

Abstract : Background: Pseudo-progression associated with ICI has been well described. HP - characterized by paradoxically accelerated tumor growth rate (TGR) - while on ICI is increasingly being recognized. Preliminary data have reported murine double minute (MDM2/MDM4) amplification as a possible predictive biomarker for HP based on pre-treatment next generation sequencing (NGS) of tumor tissue. We sought to identify patients that hyper-progressed at our institution, characterize the SAs in those patients (pts) and conversely, estimate the incidence of HP in pts with such SAs.Methods: HP was defined as: 1. progression at first restaging on ICI 2. Increase in tumor size gt; 50%, 3. gt;2-fold increase in TGR. Data were obtained by interrogating our institutional electronic medical record and molecular database (MDB). Next Generation Sequencing (NGS -Foundation Medicine, Cambridge MA) was performed on pre-treatment tumor tissue; DNA was extracted, NGS was performed on hybrid-capture, adaptor ligation based libraries to a mean coverage depth of gt; 600 for up to 315 genes plus 47 introns from 19 genes frequently rearranged in cancer.