Grand Rounds

Pseudoprogression and Immunotherapy Phenomena

Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC, and Donna Lee Gerber, CNS

From The University of Texas MD Anderson Cancer Center, Houston, Texas

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC, 1515 Holcombe Boulevard, Houston, TX. E-mail: ewaxman@mdanderson.org


J Adv Pract Oncol 2020;11(7):723–731 | https://doi.org/10.6004/jadpro.2020.11.7.6 | © 2020 Harborside™


  

ABSTRACT

Traditionally, treatment responses to chemotherapy had been based on Response Evaluation Criteria in Solid Tumours (RECIST) criteria evaluating tumor shrinkage, stabilization of disease, growth, or development of new metastatic lesions. Using the same criteria to determine response in patients on immunotherapy has proven difficult, as some patients have initial growth of disease or develop new small metastatic lesions. The phenomenon of pseudoprogression is the initial growth of a primary lesion followed by latent or delayed response. Advanced practitioners need to be aware of the possibility of pseudoprogression in order to educate patients and help them stay on effective treatment.




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