TROPHIMMUN cohort A: avelumab in gestational trophoblastic tumours resistant to single-agent chemotherapy
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.
Overview
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.
- 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.
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.
- Fifteen patients; no comparator.
- Women resistant to combination chemotherapy responded less often.
Similar pages
not linked directly; found by shared links- Key paperGOG 174: weekly methotrexate or pulsed dactinomycin for low-risk gestational trophoblastic neoplasia
Shares Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6), Journal of Clinical Oncology.
- CancerGestational trophoblastic neoplasia
Shares Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6), Avelumab.
- CancerHigh-risk gestational trophoblastic neoplasia (FIGO score 7 or more, including ultra-high-risk)
Shares Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6), Avelumab.