Combined chemotherapy and pembrolizumab salvages multi-chemotherapy agent and avelumab resistant choriocarcinoma: A case report

Case report: Multidrug resistant gestational trophoblastic neoplasia: focus on failure of immunotherapy and success of high-dose chemotherapy

“…and they showed a complete response (CR) of 75% (3/4 patients). The literature describes only case reports and series concerning the use of immunotherapy in these situations ( Table 2 ) ( 20 – 29 ). More recently Braga et al.…”

“…The use of PD-1/PDL-1 inhibitors can block this pathway, enabling T cells to destroy tumour cells (19). Given these facts, immune checkpoint inhibitors targeting PD-1 and PDL-1 appear to be effective in the treatment of GTN (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)). This appears to be a promising way of avoiding combination of chemotherapy and its effects on the quality of life of young patients.…”

“…This appears to be a promising way of avoiding combination of chemotherapy and its effects on the quality of life of young patients. Their efficacy has already been demonstrated in multidrug-resistant cases, but their role at an early stage of treatment is emerging (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

“…The first ICI used for multi-drug resistant GTN was Pembrolizumab, a PD-1 inhibitor, by Ghorani et al and they showed a complete response (CR) of 75% (3/4 patients). The literature describes only case reports and series concerning the use of immunotherapy in these situations (Table 2) (20)(21)(22)(23)(24)(25)(26)(27)(28)(29). More recently Braga et al reported a series of 3 cases of CR using this drug (25,26).…”

“…Catch-up rates with Dactinomycin and EMACO are 75% and 87% respectively. Recently, some authors have suggested that immunotherapy could be a new treatment alternative for resistant disease, and the use of Avelumab has enabled in 53% of patients to be cured (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31).…”