Incidence of immunotherapy‐related hyperprogressive disease (HPD) across HPD definitions and cancer types in observational studies: A systematic review and meta‐analysis

Abstract Background While evidence of hyperprogressive disease (HPD) continues to grow, the lack of a consensual definition obscures a proper characterization of HPD incidence. We examined how HPD incidence varies by the tumor type or the type of definition used. Methods We searched PubMed, Embase, the Cochrane Library of Systematic Reviews, and Web of Science from database inception to June 21, 2022. Observational studies reporting HPD incidence, in patients diagnosed with solid malignant tumors and treated with immune checkpoint inhibitors (ICI), were included. Random‐effects meta‐analyses were performed, and all statistical tests were 2‐sided. Results HPD incidence was 12.4% (95% CI 10.2%–15.0%) with evidence of heterogeneity (Q = 119.32, p 50). Conclusions The incidence of immunotherapy‐related HPD may vary across tumor types and definitions used, supporting the argument for a uniform and improved method of HPD evaluation for informed clinical decision‐making.