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病例报告:多药耐药性妊娠滋养细胞肿瘤:聚焦免疫治疗失败与大剂量化疗成功

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

作者信息

Enuset Anne, Duck Lionel, Petre Claudia, Machiels Jean-Pascal, Goffin Frédéric

机构信息

Department of Gynecology and Obstetrics, Université Catholique de Louvain, Brussels, Belgium.

Onco-Hematology and Palliative Care, Clinique Saint-Pierre Ottignies, Ottignies-Louvain-la-Neuve, Belgium.

出版信息

Front Oncol. 2024 May 13;14:1391408. doi: 10.3389/fonc.2024.1391408. eCollection 2024.

Abstract

Gestational trophoblastic neoplasia (GTN) is extremely rare, but has a very good prognosis, with a cure rate close to 100%, for low-risk diseases. This article describes the case of a healthy 28-year-old nulliparous patient with GTN resistant to multiple lines of treatment. The era of immunotherapy is revolutionizing oncology, having already proved its worth in the treatment of many cancers. This article will have a specific focus on the emerging role of immunotherapy in the treatment of GTN. Unfortunately, the use of an immune checkpoint inhibitor (ICI) failed in our case, emphasizing on the necessity to clearly define the future role of immune therapy in GTN. Finally, given the rapid progression of the disease after hysterectomy, induction with Paclitaxel- Ifosfamide and then intensification with high-dose Carboplatin and Etoposide with peripheral blood stem cell support was given as a rescue therapy with still curative intent.

摘要

妊娠滋养细胞肿瘤(GTN)极为罕见,但预后良好,低风险疾病的治愈率接近100%。本文描述了一名28岁健康未育的GTN患者,该患者对多线治疗耐药。免疫治疗时代正在彻底改变肿瘤学,已在许多癌症的治疗中证明了其价值。本文将特别关注免疫治疗在GTN治疗中的新兴作用。不幸的是,我们的病例中使用免疫检查点抑制剂(ICI)失败了,这凸显了明确免疫治疗在GTN未来作用的必要性。最后,鉴于子宫切除术后疾病进展迅速,给予紫杉醇-异环磷酰胺诱导治疗,随后给予高剂量卡铂和依托泊苷强化治疗,并辅以外周血干细胞支持,作为仍有治愈意图的挽救治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e4f/11128616/40be57f5db7e/fonc-14-1391408-g001.jpg

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