PURPOSE OF REVIEW: This review demonstrates the evidence for new systemic anticancer treatments and how they integrate within conventional management for gestational trophoblastic neoplasia (GTN). We present the evidence on atypical placental site nodules, and how they incorporate within the GTN spectrum, as well as updates regarding GTN staging and follow-up. RECENT FINDINGS: First-line treatment for GTN still lies in conventional chemotherapy, although the introduction of anti-PD1/PD-L1 immune checkpoint inhibitors has shown significant promise in management of relapsed disease, with responses reported in multiple relapsed choriocarcinomas as well as epithelioid trophoblastic tumours and placental site trophoblastic tumours (ETT/PSTT). Following completion of treatment, ETT/PSTT still require life-long surveillance but for other GTN, no recurrences have been detected after 7 years. SUMMARY: Checkpoint inhibitors are likely to play an increasing role in the future management of GTN management. Further refinement of prognostic factors to identify those most at risk of GTN recurrence is warranted so that surveillance can be focussed on those most at risk, whilst minimizing unnecessary intervention for those at lower risk.
PURPOSE OF REVIEW: This review demonstrates the evidence for new systemic anticancer treatments and how they integrate within conventional management for gestational trophoblastic neoplasia (GTN). We present the evidence on atypical placental site nodules, and how they incorporate within the GTN spectrum, as well as updates regarding GTN staging and follow-up. RECENT FINDINGS: First-line treatment for GTN still lies in conventional chemotherapy, although the introduction of anti-PD1/PD-L1 immune checkpoint inhibitors has shown significant promise in management of relapsed disease, with responses reported in multiple relapsed choriocarcinomas as well as epithelioid trophoblastic tumours and placental site trophoblastic tumours (ETT/PSTT). Following completion of treatment, ETT/PSTT still require life-long surveillance but for other GTN, no recurrences have been detected after 7 years. SUMMARY: Checkpoint inhibitors are likely to play an increasing role in the future management of GTN management. Further refinement of prognostic factors to identify those most at risk of GTN recurrence is warranted so that surveillance can be focussed on those most at risk, whilst minimizing unnecessary intervention for those at lower risk.
Authors: Antonio Braga; Clymene de Souza Hartung Araújo; Paulo Alexandre Ribeiro Mora; Eduardo Paulino; Andréia Cristina de Melo; Guillermo Coca Velarde; Ana Paula Vieira Dos Santos Esteves; Joffre Amim Junior; Jorge Rezende Filho; Kevin M Elias; Neil S Horowitz; Ross S Berkowitz Journal: Gynecol Oncol Date: 2020-01-10 Impact factor: 5.482
Authors: B You; M Pollet-Villard; L Fronton; C Labrousse; A-M Schott; T Hajri; P Girard; G Freyer; M Tod; B Tranchand; O Colomban; B Ribba; D Raudrant; J Massardier; S Chabaud; F Golfier Journal: Ann Oncol Date: 2010-02-12 Impact factor: 32.976
Authors: Kirsty Balachandran; Abdulazeez Salawu; Ehsan Ghorani; Baljeet Kaur; Neil J Sebire; Dee Short; Richard Harvey; Barry Hancock; John Tidy; Kamaljit Singh; Naveed Sarwar; Matthew C Winter; Michael J Seckl Journal: Gynecol Oncol Date: 2019-07-30 Impact factor: 5.482
Authors: Christianne Lok; Nienke van Trommel; Leon Massuger; François Golfier; Michael Seckl Journal: Eur J Cancer Date: 2020-04-01 Impact factor: 9.162
Authors: Arpitha Anantharaju; V R Pallavi; Uttam D Bafna; Praveen S Rathod; Vijay C R; Shobha K; Rajshekar Kundargi Journal: Int J Gynecol Cancer Date: 2019-01-29 Impact factor: 3.437
Authors: Hextan Y S Ngan; Michael J Seckl; Ross S Berkowitz; Yang Xiang; François Golfier; Paradan K Sekharan; John R Lurain; Leon Massuger Journal: Int J Gynaecol Obstet Date: 2018-10 Impact factor: 3.561
Authors: Peter Schmid; Yutaka Nagai; Roshan Agarwal; Barry Hancock; Philip M Savage; Neil J Sebire; Iain Lindsay; Michael Wells; Rosemary A Fisher; Delia Short; Edward S Newlands; Manfred B Wischnewsky; Michael J Seckl Journal: Lancet Date: 2009-06-22 Impact factor: 79.321