Gestational choriocarcinoma

Giorgio Bogani, Isabelle Ray-Coquard, David Mutch, Ignace Vergote, Pedro T. Ramirez, Jaime Prat, Nicole Concin, Natalie Yan Li Ngoi, Robert L. Coleman, Takayuki Enomoto, Kazuhiro Takehara, Hannelore Denys, Domenica Lorusso, Masashi Takano, Satoru Sagae, Pauline Wimberger, Yakir Segev, Se Ik Kim, Jae Weon Kim, Fernanda HerreraAndrea Mariani, Rebecca A. Brooks, David Tan, Biagio Paolini, Valentina Chiappa, Mariangela Longo, Francesco Raspagliesi, Pierluigi Benedetti Panici, Violante Di Donato, Giuseppe Caruso, Nicoletta Colombo, Sandro Pignata, Gianfranco Zannoni, Giovanni Scambia, Bradley J. Monk

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1504-1514
Number of pages11
JournalInternational Journal of Gynecological Cancer
Volume33
Issue number10
DOIs
StatePublished - Oct 1 2023

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