Gestational choriocarcinoma.
Details
Serval ID
serval:BIB_0AFE8D23CBFC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Gestational choriocarcinoma.
Journal
International journal of gynecological cancer
ISSN
1525-1438 (Electronic)
ISSN-L
1048-891X
Publication state
Published
Issued date
02/10/2023
Peer-reviewed
Oui
Volume
33
Number
10
Pages
1504-1514
Language
english
Notes
Publication types: Review ; Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Gestational choriocarcinoma accounts for 5% of gestational trophoblastic neoplasms. Approximately 50%, 25%, and 25% of gestational choriocarcinoma occur after molar pregnancies, term pregnancies, and other gestational events, respectively. The FIGO scoring system categorizes patients into low (score 0 to 6) and high risk (score 7 or more) choriocarcinoma. Single-agent and multi-agent chemotherapy are used in low- and high-risk patients, respectively. Chemotherapy for localized disease has a goal of eradication of disease without surgery and is associated with favorable prognosis and fertility preservation. Most patients with gestational choriocarcinoma are cured with chemotherapy; however, some (<5.0%) will die as a result of multi-drug resistance, underscoring the need for novel approaches in this group of patients. Although there are limited data due to its rarity, the treatment response with immunotherapy is high, ranging between 50-70%. Novel combinations of immune checkpoint inhibitors with targeted therapies (including VEGFR-2 inhibitors) are under evaluation. PD-L1 inhibitors are considered a potential important opportunity for chemo-resistant patients, and to replace or de-escalate chemotherapy to avoid or minimize chemotherapy toxicity. In this review, the Rare Tumor Working Group and the European Organization for Research and Treatment of Cancer evaluated the current landscape and further perspective in the management of patients diagnosed with gestational choriocarcinoma.
Keywords
Pregnancy, Female, Humans, Uterine Neoplasms/pathology, Treatment Outcome, Retrospective Studies, Choriocarcinoma/therapy, Choriocarcinoma/pathology, Gestational Trophoblastic Disease/drug therapy, Genital Neoplasms, Female, Gestational Trophoblastic Disease
Pubmed
Web of science
Create date
29/09/2023 14:09
Last modification date
24/11/2023 7:14