TY - JOUR
T1 - Gestational choriocarcinoma
AU - Bogani, Giorgio
AU - Ray-Coquard, Isabelle
AU - Mutch, David
AU - Vergote, Ignace
AU - Ramirez, Pedro T.
AU - Prat, Jaime
AU - Concin, Nicole
AU - Li Ngoi, Natalie Yan
AU - Coleman, Robert L.
AU - Enomoto, Takayuki
AU - Takehara, Kazuhiro
AU - Denys, Hannelore
AU - Lorusso, Domenica
AU - Takano, Masashi
AU - Sagae, Satoru
AU - Wimberger, Pauline
AU - Segev, Yakir
AU - Kim, Se Ik
AU - Kim, Jae Weon
AU - Herrera, Fernanda
AU - Mariani, Andrea
AU - Brooks, Rebecca A.
AU - Tan, David
AU - Paolini, Biagio
AU - Chiappa, Valentina
AU - Longo, Mariangela
AU - Raspagliesi, Francesco
AU - Panici, Pierluigi Benedetti
AU - Donato, Violante Di
AU - Caruso, Giuseppe
AU - Colombo, Nicoletta
AU - Pignata, Sandro
AU - Zannoni, Gianfranco
AU - Scambia, Giovanni
AU - Monk, Bradley J.
N1 - Publisher Copyright:
© IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85173040330&partnerID=8YFLogxK
U2 - 10.1136/ijgc-2023-004704
DO - 10.1136/ijgc-2023-004704
M3 - Article
C2 - 37758451
AN - SCOPUS:85173040330
SN - 1048-891X
VL - 33
SP - 1504
EP - 1514
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
IS - 10
ER -