# TROPHIMMUN cohort A: avelumab in gestational trophoblastic tumours resistant to single-agent chemotherapy

Source: https://onco.cc/key-papers/paper-trophimmun-avelumab-chemoresistant-gtn-jco-2020/  
OnCo record `paper-trophimmun-avelumab-chemoresistant-gtn-jco-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The first trial of immunotherapy in gestational trophoblastic disease found that the PD-L1 antibody avelumab cured about half of women whose tumours had stopped responding to a single chemotherapy drug, sparing them combination chemotherapy.

## Summary

French multicentre single-arm phase 2 trial of 15 women with gestational trophoblastic tumours resistant to single-agent methotrexate or dactinomycin, treated with avelumab every two weeks until hCG normalised and for three further cycles.

Eight of 15 women (53 percent) achieved hCG normalisation and remained in remission, one later had a normal pregnancy; toxicity was mild. Cohort B, in women resistant to combination chemotherapy, was less successful.

## Fields

- Kind: Key paper
- Last checked: 2026-09-18
- Journal: Journal of Clinical Oncology
- Year: 2020
- DOI: 10.1200/JCO.20.00803
- Authors: You B, Bolze PA, Lotz JP, et al.
- Findings: hCG normalisation in 8 of 15 women (53 percent) with single-agent-resistant GTN, with durable remissions.; Mild toxicity and at least one subsequent healthy pregnancy.
- What it means: Immunotherapy is a real option for chemotherapy-resistant GTN, building on the extraordinary PD-L1 expression of trophoblast; the TROPHAMET trial is testing avelumab with methotrexate first line.
- Caveats: Fifteen patients; no comparator.; Women resistant to combination chemotherapy responded less often.

## Sources

- J Clin Oncol 2020: https://doi.org/10.1200/JCO.20.00803
- PubMed: https://pubmed.ncbi.nlm.nih.gov/32716740/

## Connected records

- cancers: [Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6)](https://onco.cc/cancers/low-risk-gtn/)
- drugs: [Avelumab](https://onco.cc/drugs/avelumab/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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