Current Evidence on Immunotherapy for Gestational Trophoblastic Neoplasia (GTN)
Abstract
:Simple Summary
Abstract
1. Introduction
1.1. Gestational Trophoblastic Disease
1.2. Standard Treatment in Gestational Trophoblastic Neoplasia
2. Materials and Methods
3. Results
Immunotherapy and GTN
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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FIGO STAGING | |
---|---|
Stage I | GTN confined to the uterus |
Stage II | GTN extends to the other genital structures |
Stage III | GTN extends to the lungs, with or without genital tract involvement |
Stage IV | All other distant metastases |
Prognostic Factors | Score 1 | Score 2 | Score 3 | Score 4 |
---|---|---|---|---|
Age | <40 | > or =40 | ||
Antecedent gestation | Mole | Abortion | Term | |
Interval in months prior to end of antecedent pregnancy and start of treatment | <4 | 4–6 | 7–12 | >12 |
Largest tumor size | <3 | 3–4 | > or =5 | |
Site of metastases | Lung | Spleen, kidney | Gastrointestinal tract | Brain, liver |
Number of metastases | 1–4 | 5–8 | >8 | |
Pretreatment serum hCG (IU/L) | <103 | 103–104 | 104–105 | >105 |
Previously failed chemotherapy | Single drug | Two or more drugs |
References | Tumor Type | PD-L1 Expression | Pembrolizumab Cycles to hCG Normalization | Pembrolizumab Cycles as Consolidation | Response |
---|---|---|---|---|---|
Huang et al., 2017 [45] | Choriocarcinoma | Strong | 2 | 4 | CR |
Ghorani et al., 2017 [46] | Choriocarcinoma | 100% | 4 | 5 | CR |
PSTT/ETT | >90% | 5 | 0 | PD | |
PSTT | >90% | 8 | 5 | CR | |
Choriocarcinoma | 100% | 2 | 5 | CR | |
Chul Choi et al., 2019 [47] | PSTT | 100% | 1 | 13 | CR |
ETT | 50% | 11 | 4 | PR | |
Goldfarb et al., 2020 [48] | Choriocarcinoma | 100% | 3 | 3 | CR |
Clair et al., 2020 [49] | Choriocarcinoma | Strong | 10 | 0 | CR |
Pisani et al., 2021 [50] | ETT | Not evaluated | Undeclared | Undeclared | CR |
Bell et al., 2021 [51] | ETT | >5% | Ongoing | Ongoing | PR (Cut-off of 29 cycles) |
Paspalj et al., 2021 [52] | Choriocarcinoma | >90% | 4 | 7 | CR |
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Mangili, G.; Sabetta, G.; Cioffi, R.; Rabaiotti, E.; Candotti, G.; Pella, F.; Candiani, M.; Bergamini, A. Current Evidence on Immunotherapy for Gestational Trophoblastic Neoplasia (GTN). Cancers 2022, 14, 2782. https://doi.org/10.3390/cancers14112782
Mangili G, Sabetta G, Cioffi R, Rabaiotti E, Candotti G, Pella F, Candiani M, Bergamini A. Current Evidence on Immunotherapy for Gestational Trophoblastic Neoplasia (GTN). Cancers. 2022; 14(11):2782. https://doi.org/10.3390/cancers14112782
Chicago/Turabian StyleMangili, Giorgia, Giulia Sabetta, Raffaella Cioffi, Emanuela Rabaiotti, Giorgio Candotti, Francesca Pella, Massimo Candiani, and Alice Bergamini. 2022. "Current Evidence on Immunotherapy for Gestational Trophoblastic Neoplasia (GTN)" Cancers 14, no. 11: 2782. https://doi.org/10.3390/cancers14112782