Oliver Dorigo, MD, PhD

COMMENTING ON the study, invited discussant Oliver Dorigo, MD, PhD, of Stanford University, said that tumor size and disease site are useful clinical parameters for predicting nonresponse to immunotherapy and should be considered when selecting and “unselecting” patients for immunotherapy treatment. The research also supports the use of immunotherapy earlier in the treatment course, he added. 

However, Dr. Dorigo warned that immune checkpoint blockade can generate unusual response patterns, including pseudoprogression, hyperprogression, as well as delayed and abscopal responses, possibly explaining the 57% of patients who discontinued treatment early because of radiographic disease progression. Additionally, in the 43% of patients who discontinued treatment due to clinical disease progression with pain and ascites, their symptoms might have been unrelated to their disease and exacerbated by immunotherapy, he noted. ■

DISCLOSURE: Dr. Dorigo reported no conflicts of interest.