American Association for Cancer Research
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Supplementary Figure S4 from Better than RECIST and Faster than iRECIST: Defining the Immunotherapy Progression Decision Score to Better Manage Progressive Tumors on Immunotherapy

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journal contribution
posted on 2023-04-14, 08:22 authored by Younes Belkouchi, Hugues Talbot, Nathalie Lassau, Littisha Lawrance, Siham Farhane, Rahma Feki-Mkaouar, Joya Hadchiti, Lama Dawi, Julien Vibert, Paul-Henry Cournède, Clara Cousteix, Camille Mazza, Michele Kind, Antoine Italiano, Aurelien Marabelle, Samy Ammari, Stephane Champiat

Log Hazard ratio (HR) of each parameter obtained from a cox model fitted to predict survival.


Université Paris-Saclay (University of Paris-Saclay)



The objective of the study is to propose the immunotherapy progression decision (iPD) score, a practical tool based on patient features that are available at the first evaluation of immunotherapy treatment, to help oncologists decide whether to continue the treatment or switch rapidly to another therapeutic line when facing a progressive disease patient at the first evaluation. This retrospective study included 107 patients with progressive disease at first evaluation according to RECIST 1.1. Clinical, radiological, and biological data at baseline and first evaluation were analyzed. An external validation set consisting of 31 patients with similar baseline characteristics was used for the validation of the score. Variables were analyzed in a univariate study. The iPD score was constructed using only independent variables, each considered as a worsening factor for the survival of patients. The patients were stratified in three groups: good prognosis (GP), poor prognosis (PP), and critical prognosis (CP). Each group showed significantly different survivals (GP: 11.4, PP: 4.4, CP: 2.3 months median overall survival, P < 0.001, log-rank test). Moreover, the iPD score was able to detect the pseudoprogressors better than other scores. On the validation set, CP patients had significantly worse survival than PP and GP patients (P < 0.05, log-rank test). The iPD score provides oncologists with a new evaluation, computable at first progression, to decide whether treatment should be continued (for the GP group), or immediately changed for the PP and CP groups. Further validation on larger cohorts is needed to prove its efficacy in clinical practice.

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