Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature review

ObjectiveTo investigate the risk factors, underlying mechanisms, and preventive strategies associated with hyperprogressive disease (HPD) induced by immunotherapy.MethodsWe analyzed the clinical data of a patient who developed HPD following palliative gastrectomy and received a combination therapy o...

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Main Authors: Yaoqi Li, You Wang, Rui Shen, Weijun Liu, Chenglou Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1494007/full
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author Yaoqi Li
You Wang
Rui Shen
Weijun Liu
Chenglou Zhu
Chenglou Zhu
author_facet Yaoqi Li
You Wang
Rui Shen
Weijun Liu
Chenglou Zhu
Chenglou Zhu
author_sort Yaoqi Li
collection DOAJ
description ObjectiveTo investigate the risk factors, underlying mechanisms, and preventive strategies associated with hyperprogressive disease (HPD) induced by immunotherapy.MethodsWe analyzed the clinical data of a patient who developed HPD following palliative gastrectomy and received a combination therapy of Sintilimab, S-1 (tegafur, gimeracil, and oteracil potassium), and Oxaliplatin (SOX). Additionally, a literature review on tumor immunotherapy was conducted to further explore the risk factors and mechanisms of HPD.ResultsIn this case, the development of HPD was associated with a high postoperative tumor burden, elevated PD-1 expression, and aberrant activation of signaling pathways mediated by EGFR, MET, and FGFR1 amplifications. In addition, a TP53 p.F270V mutation led to inactivation of tumor suppressor function.ConclusionAlthough immune checkpoint inhibitors (ICIs) have demonstrated significant efficacy in cancer treatment, HPD induced by ICIs can drastically shorten patients’ OS, warranting cautious use in populations with high-risk factors. Effective prevention of HPD involves screening for risk factors, monitoring predictive biomarkers such as circulating-free DNA (cfDNA) via liquid biopsy, and identifying high-risk populations through gene mutation analysis.
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spelling doaj-art-cb83aebdeb4946698a53da425e7f034e2025-08-20T03:47:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.14940071494007Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature reviewYaoqi Li0You Wang1Rui Shen2Weijun Liu3Chenglou Zhu4Chenglou Zhu5Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, ChinaThe First School of Clinical Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, ChinaDepartment of General Surgery, Chengxian People’s Hospital, Chengxian, ChinaDepartment of General Surgery, Longxi County First People’s Hospital, Longxi, ChinaDepartment of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, ChinaThe First School of Clinical Medicine, Lanzhou University, Lanzhou, ChinaObjectiveTo investigate the risk factors, underlying mechanisms, and preventive strategies associated with hyperprogressive disease (HPD) induced by immunotherapy.MethodsWe analyzed the clinical data of a patient who developed HPD following palliative gastrectomy and received a combination therapy of Sintilimab, S-1 (tegafur, gimeracil, and oteracil potassium), and Oxaliplatin (SOX). Additionally, a literature review on tumor immunotherapy was conducted to further explore the risk factors and mechanisms of HPD.ResultsIn this case, the development of HPD was associated with a high postoperative tumor burden, elevated PD-1 expression, and aberrant activation of signaling pathways mediated by EGFR, MET, and FGFR1 amplifications. In addition, a TP53 p.F270V mutation led to inactivation of tumor suppressor function.ConclusionAlthough immune checkpoint inhibitors (ICIs) have demonstrated significant efficacy in cancer treatment, HPD induced by ICIs can drastically shorten patients’ OS, warranting cautious use in populations with high-risk factors. Effective prevention of HPD involves screening for risk factors, monitoring predictive biomarkers such as circulating-free DNA (cfDNA) via liquid biopsy, and identifying high-risk populations through gene mutation analysis.https://www.frontiersin.org/articles/10.3389/fonc.2025.1494007/fullgastric cancerHPDsintilimabrisk factorsmechanisms
spellingShingle Yaoqi Li
You Wang
Rui Shen
Weijun Liu
Chenglou Zhu
Chenglou Zhu
Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature review
Frontiers in Oncology
gastric cancer
HPD
sintilimab
risk factors
mechanisms
title Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature review
title_full Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature review
title_fullStr Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature review
title_full_unstemmed Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature review
title_short Hyperprogression disease induced by Sintilimab combined with Oxaliplatin and S-1 after surgery: a case report and literature review
title_sort hyperprogression disease induced by sintilimab combined with oxaliplatin and s 1 after surgery a case report and literature review
topic gastric cancer
HPD
sintilimab
risk factors
mechanisms
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1494007/full
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