Table 1.

Proposed criteria of Hyperprogressive disease.

Tumor measurement criteria

1- Increase of two-fold or higher per RECIST 1.1 criteria OR 50% or higher increase in tumor burden compared to pretreatment imaging

2- Time to progression less than 3 cycles of therapy (2 months)

3- 2-fold or higher increase in progression pace

4- Progression of new lesions

Patient symptoms criteria

5- Rapid decrease in baseline performance status or worsening of symptoms related to the disease progression

6- New onset of complications related to disease progression i.e. SVC, increase pleural effusion

Laboratory Criteria

7- LDH > upper limit of normal

Measurement Methods

Tumor Growth Rate (TGR) 3 D difference in tumor volume per month, related to the sum of the target lesion(s) diameter(s) as well as the time between imaging evaluations.

Tumor Growth Kinetics (TGK) 2D as a function of tumor diameter over time.

Potential Factors associated with HYD

1. Increased Age

2. Higher tumor burden with 2 or more metastatic sites with one of the liver

3. High LDH