Purpose This study aimed to develop postsurgical progression/hyperprogression recurrence (type III-IV recurrence) prediction models for hepatocellular carcinoma (HCC) patients with macroscopic vascular invasion (MaVI) and to guide treatment strategies in the accurate healthcare era. Patients and methods 393 HCC patients with MaVI from two central hospitals made up the entire study population. In developmental (290 patients) and validation (103 patients) cohorts, all patients were randomized into one or the other. Two prediction models for type III-IV recurrence were developed, based on the findings of univariate and multivariate analysis in the development cohort, and multidimensional verification was carried out in both cohorts. Results The postoperative recurrence rate of type III-IV in 393 HCC patients with MaVI was 70.9%. Young age, large tumor size (≥ 10 cm), node number, incomplete tumor capsule, postoperative complications, and high Ki67 index were the independent risk factors for relapse of type III-IV. In the development cohort, two nomograms (pre- and postoperative) had the Area Under the ROC curve (AUC) of 0.827 and 0.891, respectively. The two nomograms performed well, according to multidimensional verification methods such as clinical impact curves, decision curve analysis (DCA), and calibration curves. The validation cohort saw similar encouraging results. Both nomograms could separate patients into two distinct prognosis subgroups with ideal cutoff values of 170.3 presurgery and 175.0 postsurgery (both P < 0.05). Conclusion We constructed two novel and potentially clinically valuable models for predicting type III-IV recurrence. These two models can develop strategies for treating those suffering from HCC with MaVI owing to their strong prediction performance and availability.

Abstract Immunotherapy, particularly immune checkpoint inhibitors, plays a crucial role in the treatment of brain metastases in various primary cancers. Response assessment encompasses atypical…

Researchers at The University of Texas MD Anderson Cancer Center have found that renal medullary carcinoma (RMC) cells use an adaptive mechanism called "myeloid mimicry" to hide from the immune system and promote disease hyperprogression after immunotherapy, highlighting specific targets that overcome treatment resistance in preclinical models.

The tumor-intrinsic NOD-, LRR- and pyrin domain-containing protein-3 (NLRP3) inflammasome-heat shock protein 70 (HSP70) signaling axis is triggered by CD8⁺ T cell cytotoxicity and contributes to the development of adaptive resistance to anti-programmed cell death protein 1 (PD-1) immunoth …

Researchers at The University of Texas MD Anderson Cancer Center have found that renal medullary carcinoma (RMC) cells use an adaptive mechanism called "myeloid mimicry" to hide from the immune system and promote disease hyperprogression after immunotherapy, highlighting specific targets that overcome treatment resistance in preclinical models.

Researchers at The University of Texas MD Anderson Cancer Center have found that renal medullary carcinoma (RMC) cells use an adaptive mechanism called "myeloid mimicry" to hide from the immune system and promote disease hyperprogression after immunotherapy, highlighting specific targets that overcome treatment resistance in preclinical models.

The introduction of immune checkpoint inhibitors (ICIs) has transformed the treatment landscape across multiple tumor types, producing durable responses and meaningful survival improvements for many patients. However, a small subset of patients experience a paradoxical phenomenon known as hyperprogressive disease (HPD), characterized by an unexpectedly rapid acceleration of tumor growth shortly after the initiation of immunotherapy. Despite growing recognition of HPD, its true incidence, biological basis, and clinical implications remain incompletely understood. A recent multicenter French study, HYPERPROG, provides one of the largest real-world analyses of hyperprogression reported to date and offers important insights into its clinical behavior. What Is Hyperprogressive Disease? Hyperprogression was first described in 2017 when investigators observed that some patients treated with PD-1 or PD-L1 inhibitors experienced tumor growth that was substantially faster than expected from the natural history of their disease. Since then, multiple studies have attempted to characterize this phenomenon, but differing definitions have resulted in widely varying estimates of prevalence and inconsistent conclusions regarding its prognostic significance. The HYPERPROG investigators focused on clinically meaningful cases by requiring both a marked increase in tumor growth rate and clinical deterioration. This approach was intended to identify patients experiencing true hyperprogression rather than conventional disease progression...

Introduction: Immune checkpoint inhibitors (ICIs) may be associated with hyperprogressive disease (H