Effectiveness and Safety of Toripalimab Combination Therapies for Patients With Chemo-Resistant Choriocarcinoma

Liu, Xiaomei; Li, Xiuqin; Qu, Hui; Zhang, Shiyue; Zhang, Ruizhe; Du, Zhenmin

doi:10.3389/fonc.2022.815917

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Favorable outcomes, including complete responses, were observed in cases with strong PD-L1 expression (often 90%-100%) (37)(38)(39)(40)(41)(42)(43). Additionally, toripalimab and tirelizumab showed promise in chemo-resistant choriocarcinoma (44,45).In a phase 2 clinical trial, the combination of camrelizumab and apatinib showed potential for chemo-resistant choriocarcinoma, with a 50% complete response rate (46). In the TROPHIMMUN trial, avelumab also demonstrated curative potential in 50% chemotherapy-resistant gestational trophoblastic tumors, including cases of choriocarcinoma (47).…”

Section: Discussionmentioning

confidence: 99%

Case report: Molecular profiling facilitates the diagnosis of a challenging case of lung cancer with choriocarcinoma features

Li,

Hu,

Ning

et al. 2024

Front. Oncol.

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Accurate diagnoses are crucial in determining the most effective treatment across different cancers. In challenging cases, morphology-based traditional pathology methods have important limitations, while molecular profiling can provide valuable information to guide clinical decisions. We present a 35-year female with lung cancer with choriocarcinoma features. Her disease involved the right lower lung, brain, and thoracic lymph nodes. The pathology from brain metastasis was reported as “metastatic choriocarcinoma” (a germ cell tumor) by local pathologists. She initiated carboplatin and etoposide, a regimen for choriocarcinoma. Subsequently, her case was assessed by pathologists from an academic cancer center, who gave the diagnosis of “adenocarcinoma with aberrant expression of β-hCG” and finally pathologists at our hospital, who gave the diagnosis of “poorly differentiated carcinoma with choriocarcinoma features”. Genomic profiling detected a KRAS G13R mutation and transcriptomics profiling was suggestive of lung origin. The patient was treated with carboplatin/paclitaxel/ipilimumab/nivolumab followed by consolidation radiation therapy. She had no evidence of progression to date, 16 months after the initial presentation. The molecular profiling could facilitate diagnosing of challenging cancer cases. In addition, chemoimmunotherapy and local consolidation radiation therapy may provide promising therapeutic options for patients with lung cancer exhibiting choriocarcinoma features.

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Section: Discussionmentioning

confidence: 99%

Case report: Molecular profiling facilitates the diagnosis of a challenging case of lung cancer with choriocarcinoma features

Li,

Hu,

Ning

et al. 2024

Front. Oncol.

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“…Etoposide, carboplatin, bleomycin, and methotrexate are examples of common chemotherapy drugs ( 3 , 6 ). Furthermore, patients with choriocarcinoma who are resistant to chemotherapeutic drugs can be treated with a combination of toripalizumab and surgery ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

The tumor or inflammation? a case report on primary pulmonary choriocarcinoma

Wang

Zhang

et al. 2023

Front. Oncol.

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Choriocarcinoma is a rare malignant germ cell neoplasm with high invasiveness, the majority of which are pregnancy-related, and the female genital tract is the most prevalent site of the disease. Although early-stage choriocarcinoma typically metastasizes to the lungs, primary pulmonary choriocarcinoma is extremely rare. Primary pulmonary choriocarcinoma is difficult to diagnose, and it progresses rapidly. Combined with the difficulty of treatment, the prognosis of patients is generally poor. In this article, we retrospectively analyzed a case of female primary pulmonary choriocarcinoma, combined with a review of literature, to understand and describe the diagnostic and treatment progress of PPC.

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“…Liu et al [ 22 ] reported a series of 4 patients with multidrug resistant disease who were all treated with the anti-PD-1 agent toripalimab ( Table 1 ). Toripalimab was not given as monotherapy but combined with chemotherapy in all 4 patients (1 patient received nab-paclitaxel and bevacizumab with toripalimab, the other 3 patients paclitaxel and cisplatin).…”

Section: Immunotherapy For Patients With High-risk Chemotherapy Insen...mentioning

confidence: 99%

“…The majority are case reports or small series of patients with multidrug resistant GTN, but evidence for the use of CPIs in an earlier setting, e.g., low-risk disease resistant to singleagent chemotherapy, is emerging [21]. Most patients have been treated with pembrolizumab, but other anti-PD1 agents have been successfully used [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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Immunotherapy for Gestational Trophoblastic Neoplasia: A New Paradigm

Baas,

Westermann,

You

et al. 2023

Gynecol Obstet Invest

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Background Immune checkpoint immunotherapy (CPI) targeting PD1/PD-L1 has been shown to be an effective treatment for gestational trophoblastic neoplasia (GTN). This includes those with multidrug resistance, ultra-high risk disease and ETT/PSTT subtypes that are inherently chemotherapy resistant, but there is also emerging evidence in low-risk disease. Objectives We set out to generate an overview of the current data supporting the use of CPI for GTN in both high risk and low risk disease and to consider future research goals and directions in order to implement CPI in current treatment guidelines. Methods We identified and reviewed the published data on the use of CPI agents in GTN. Outcome 133 patients were identified who had been treated with CPI for GTN with pembrolizumab (23), avelumab (22), camrelizumab (57), toripalimab (15) or other anti-PD-1 agents (16), of whom 118 had high risk disease, relapse or multi drug resistant disease, and 15 low risk disease. Overall 85 patients achieved complete remission, 77 (of 118) with high risk disease and 8 (of 15) with low risk disease. 1 patient with complete remission in the high risk group developed a relapse 22 months after anti-PD-1 treatment had been stopped. Treatment was generally well tolerated across studies. Conclusions and Outlook The majority of high risk patients (77/118) treated with CPI are cured and this is particularly relevant amongst those with chemotherapy resistant disease who otherwise have very limited treatment options. Priorities for future research include determining whether these agents have a role earlier in the disease course, the utility of combination with chemotherapy, and effects on future fertility. Treatment availability remains a concern due to the high price of these agents.

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Effectiveness and Safety of Toripalimab Combination Therapies for Patients With Chemo-Resistant Choriocarcinoma

Cited by 4 publications

References 22 publications

Case report: Molecular profiling facilitates the diagnosis of a challenging case of lung cancer with choriocarcinoma features

Case report: Molecular profiling facilitates the diagnosis of a challenging case of lung cancer with choriocarcinoma features

The tumor or inflammation? a case report on primary pulmonary choriocarcinoma

Immunotherapy for Gestational Trophoblastic Neoplasia: A New Paradigm

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