Early Gastrointestinal Progression to Immunotherapy in LungCancer: A Report of Two Cases

Intestinal and pancreatic metastases are rare and often challenging to recognize and manage. Lung cancer patients with entericinvolvement usually display poor outcomes. Hyperprogression to immunotherapy represents a concern, even though there iscurrently no agreement on its exact definition. Gastrointestinal hyperprogression to immune checkpoint inhibitors has not beendescribed so far. In these cases, distinguishing disease-related symptoms from immune-related adverse events may represent adiagnostic conundrum. Here, we report two cases of non-small-cell lung cancer experiencing a rapid pancreatic and colicprogression to immunotherapy, respectively. While further investigations to identify biomarkers associated withhyperprogression are warranted, clinicians should be aware of the potential unusual clinical presentations of this phenomenon.