TROPHIMMUN cohort A: avelumab in gestational trophoblastic tumours resistant to single-agent chemotherapy
The PD-L1 antibody avelumab cured about half of women whose gestational trophoblastic tumour had stopped responding to single-drug chemotherapy, with mild side effects.
Overview
Single-arm phase 2 trial at the Hospices Civils de Lyon: 15 women with gestational trophoblastic tumours resistant to methotrexate (all) or actinomycin D received avelumab 10 mg/kg every two weeks until hCG normalised and for three further cycles.
Eight women (53.3 percent) reached normal hCG after a median of nine cycles and none relapsed at a median follow-up of 25 months; one later had a healthy pregnancy. Grade 1 to 2 treatment-related adverse events occurred in 93 percent (fatigue, nausea or vomiting, infusion reactions); the seven non-responders were cured with actinomycin D or combination chemotherapy and surgery.
- hCG normalisation in 8 of 15 women (53.3 percent) after a median of 9 cycles; no subsequent relapse.
- Grade 1 to 2 treatment-related adverse events in 93 percent; one unrelated grade 3 uterine bleed.
Avelumab is a chemotherapy-sparing option for single-agent-resistant gestational trophoblastic neoplasia, particularly where the alternative is combination chemotherapy.
- Fifteen patients; cohort B later showed little activity after combination chemotherapy failure.
Similar pages
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