Post hoc analysis of association of patterns of progressive disease after immunotherapy with postprogression survival

Progressive disease (PD) in patients treated with immune checkpoint inhibitors varies widely in outcomes according to RECIST version 1.1. Post hoc analysis of 5 phase 3 trials of atezolizumab for renal cell carcinoma (RCC), urothelial carcinoma, small cell lung cancer, non-small cell lung cancer, and melanoma, respectively, investigated the association of PD patterns with postprogression survival. In RCC, 7 PD patterns significantly affected prognosis. A modified PD classification was developed that categorized PD into 3 risk levels (low, intermediate, and high) based on the progession of existing lesions and the presence of new lesions. This score was associated with postprogressions survival, and its validity was confirmed across multiple tumor types. The authors conclude that the modified PD classification enhances the prediction of survival in patients treated with immune checkpoint inhibitors.