Figure 2.

Illustration of hyperprogression under immunotherapy. A 53-year-old female patient with metastatic (lung) submandibular gland epidermoid carcinoma was treated in third line with weekly Methotrexate. After 4 months, patient experienced disease progression with appearance of lung, hepatic, and bone metastases. As fourth line, she received Nivolumab, an anti-PD-1 inhibitor. After 4 injections, she presented with major dyspnea with massive disease progression on computed-tomography (CT) scan. She died 64 days after immunotherapy initiation.