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Current chemotherapeutic options for the treatment of gestational trophoblastic disease. | LitMetric

Current chemotherapeutic options for the treatment of gestational trophoblastic disease.

Expert Opin Pharmacother

New England Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.

Published: February 2023

AI Article Synopsis

  • Gestational trophoblastic neoplasia (GTN) is a rare tumor from trophoblastic tissue, commonly arising after events like miscarriage or hydatidiform mole, and has high remission rates with chemotherapy.
  • Studies from various databases have reviewed GTN treatment, emphasizing the importance of timely diagnosis and treatment strategies.
  • Treatment options include multiagent chemotherapy for early and advanced cases, while surgery is reserved for specific situations, and resistance can be treated with either salvage chemotherapy or immunotherapy.

Article Abstract

Introduction: Gestational trophoblastic neoplasia (GTN) is a rare tumor that arises from trophoblastic tissues with high remission rates after chemotherapy treatment. GTN can develop from any gestational events, such as miscarriage, ectopic pregnancy, and preterm/term pregnancy, but is more frequent after hydatidiform mole. The sensitivity of this tumor to chemotherapy and the presence of an exceptional tumor marker allow high remission rates, especially when patients are treated in referral centers.

Areas Covered: Observational, retrospective, prospective, systematic reviews, and meta-analysis studies focusing on GTN treatment. We searched PubMed, Medline, and the Library of Congress from January 1965 to May 2022.

Expert Opinion: Early GTN diagnosis allows low-toxic and highly effective treatment. Even multimetastatic disease has high rates of remission with multiagent regimen chemotherapy. Surgery is reserved for uterine disease in patients who have completed childbearing, in cases of chemoresistance to multiagent regimens or in the rare cases of placental site trophoblastic tumor or epithelioid trophoblastic tumor. While resistance is managed by salvage chemotherapy, cases with limited clinical response to sequential regimens have been successfully treated with immunotherapy.

Download full-text PDF

Source
http://dx.doi.org/10.1080/14656566.2022.2150075DOI Listing

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