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Fig. 3 | BMC Cancer

Fig. 3

From: Hyperprogression after immunotherapy in patients with malignant tumors of digestive system

Fig. 3

Serial imaging before and after immunotherapy in the five hyperprogressors. Pre-baseline imaging refers to images about 2 months before immunotherapy. Baseline imaging refers to imaging immediately before immunotherapy. a, Case #1: patient with right colon signet-ring cell carcinoma. Restaging imaging done 1.2 months after starting atezolizumab showed multiple new metastases including right breast, bilateral ovaries et al. (863% increase from baseline imaging). Patient died 3.6 months from starting atezolizumab. b, Case #2: patient with gastric adenocarcinoma. The first evaluation done 1.4 months after the initiation of atezolizumab revealed a rapid progression of liver masses as well as new liver metastasis (107% increase from baseline imaging). Patient subsequently received liver interventional therapy and died 7.4 months from the initiation of atezolizumab. c, Case #3: patient with colon NEC. After two cycle’s atezolizumab therapy, patient presented severe abdominal distension, scans (0.94 months post atezolizumab) showed rapid progression of the peritoneum and liver metastases and new brain and adrenal gland metastases (139% increase from baseline imaging). Patient died 2.1 months from starting atezolizumab. d, Case #4: patient with gastric NEC. CT scans (1.4 months post atezolizumab) revealed a 44% increase in the liver mass and died 5.6 months from the initiation of atezolizumab. e, Case #5: patient with esophagus NEC. Patient had an incomplete bowel obstruction after immunotherapy and scans (1.2 months post durvalumab and tremelimumab) showed new lung, liver, T10–12 and L2–4 metastases (538% increase from baseline imaging). He died 3.8 months from starting durvalumab and tremelimumab

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