This paper reports a 45-year-old female patient with lung squamous cell carcinoma who received chemotherapy for multiple systemic metastases, and then 171 mg of the immune checkpoint inhibitor serplulimab was added, ivd, d1 (21 d as a cycle). After 2 cycles of treatment, the patient developed dizziness and nausea, and tumor brain metastasis was considered. The lung CT showed that the irregular mass shadow in the anterior segment of the upper lobe of the right lung was enlarged compared with the previous one, and MRI of the liver showed patchy abnormal signal in the liver segment IV. PET-CT showed that the lung, liver, adrenal gland, left groin and multiple bones were all progressed compared with the previous progress. It was considered to be tumor hyperprogression caused by serplulimab. Serplulimab was immediately discontinued and methylprednisolone was given for symptomatic treatment, but the patient still died due to overprogression. The Naranjo's Assessment Scale was used to evaluate the correlation between the tumor progression and serplulimab in this case, and the result was' likely to be related'. This case suggested that, the prognosis of tumor hyperprogression caused by immune checkpoint inhibitors has a poor prognosis, the clinical use of immune checkpoint inhibitors should be alert to this situation, and pay attention to early differential diagnosis and timely treatment to avoid serious consequences.

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