Immunotherapy in gestational trophoblastic neoplasia: advances and future directions
Gestational trophoblastic neoplasia (GTN) is a rare but aggressive malignancy that follows normal or aberrant pregnancies. Until the advent of immunotherapy in 2017, surgery and chemotherapy were the standard treatment modalities, with chemotherapy remaining the cornerstone. However, chemoresistance...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1544585/full |
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| author | Jing Zeng Jing Zeng Jing Zhang Jing Zhang Jianzhang Wang Lian Xu Lian Xu Cheng Wang Cheng Wang Rutie Yin Rutie Yin |
| author_facet | Jing Zeng Jing Zeng Jing Zhang Jing Zhang Jianzhang Wang Lian Xu Lian Xu Cheng Wang Cheng Wang Rutie Yin Rutie Yin |
| author_sort | Jing Zeng |
| collection | DOAJ |
| description | Gestational trophoblastic neoplasia (GTN) is a rare but aggressive malignancy that follows normal or aberrant pregnancies. Until the advent of immunotherapy in 2017, surgery and chemotherapy were the standard treatment modalities, with chemotherapy remaining the cornerstone. However, chemoresistance and high-risk disease present significant challenges in managing GTN. Recent advancements in immunotherapy, particularly immune checkpoint inhibitors (ICIs), have offered new hope for managing these difficult cases. This review provides the comprehensive overview of the mechanisms underlying ICIs in GTN, and explores the potential synergy of combining ICIs with targeted therapies, such as vascular endothelial growth factor and epidermal growth factor receptor inhibitors. We also provide an overview of the latest evidence on the use of ICIs in treating GTN, focusing on their effectiveness in both low- and high-risk cases, as well as in chemorefractory settings. In addition, we discuss ongoing clinical trials, immune-related adverse events associated with ICIs, biomarker-driven approaches, immunosuppressive tumor microenvironments, and the challenges posed with ICIs resistance. The review also explores future directions, including the integration of ICIs into standard regimens, the potential for personalized treatment based on tumor biology, and the importance of fertility preservation in young patients with GTN. In conclusion, while challenges remain, immunotherapy represents a promising frontier in GTN treatment, with the potential to improve outcomes and provide a more personalized approach to care |
| format | Article |
| id | doaj-art-ca9dcc2779604e7daf25cc252d68ab1e |
| institution | OA Journals |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-ca9dcc2779604e7daf25cc252d68ab1e2025-08-20T02:09:35ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-04-011610.3389/fimmu.2025.15445851544585Immunotherapy in gestational trophoblastic neoplasia: advances and future directionsJing Zeng0Jing Zeng1Jing Zhang2Jing Zhang3Jianzhang Wang4Lian Xu5Lian Xu6Cheng Wang7Cheng Wang8Rutie Yin9Rutie Yin10Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, ChinaJoint Laboratory of Reproductive Medicine (SCU-CUHK), West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaWest China School of Medicine, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, ChinaDepartment of Pathology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, ChinaDepartment of Pathology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, ChinaGestational trophoblastic neoplasia (GTN) is a rare but aggressive malignancy that follows normal or aberrant pregnancies. Until the advent of immunotherapy in 2017, surgery and chemotherapy were the standard treatment modalities, with chemotherapy remaining the cornerstone. However, chemoresistance and high-risk disease present significant challenges in managing GTN. Recent advancements in immunotherapy, particularly immune checkpoint inhibitors (ICIs), have offered new hope for managing these difficult cases. This review provides the comprehensive overview of the mechanisms underlying ICIs in GTN, and explores the potential synergy of combining ICIs with targeted therapies, such as vascular endothelial growth factor and epidermal growth factor receptor inhibitors. We also provide an overview of the latest evidence on the use of ICIs in treating GTN, focusing on their effectiveness in both low- and high-risk cases, as well as in chemorefractory settings. In addition, we discuss ongoing clinical trials, immune-related adverse events associated with ICIs, biomarker-driven approaches, immunosuppressive tumor microenvironments, and the challenges posed with ICIs resistance. The review also explores future directions, including the integration of ICIs into standard regimens, the potential for personalized treatment based on tumor biology, and the importance of fertility preservation in young patients with GTN. In conclusion, while challenges remain, immunotherapy represents a promising frontier in GTN treatment, with the potential to improve outcomes and provide a more personalized approach to carehttps://www.frontiersin.org/articles/10.3389/fimmu.2025.1544585/fullgestational trophoblastic neoplasiaimmune checkpoint inhibitorschemoresistanceclinical trialsfertility preservationimmune-related adverse events |
| spellingShingle | Jing Zeng Jing Zeng Jing Zhang Jing Zhang Jianzhang Wang Lian Xu Lian Xu Cheng Wang Cheng Wang Rutie Yin Rutie Yin Immunotherapy in gestational trophoblastic neoplasia: advances and future directions Frontiers in Immunology gestational trophoblastic neoplasia immune checkpoint inhibitors chemoresistance clinical trials fertility preservation immune-related adverse events |
| title | Immunotherapy in gestational trophoblastic neoplasia: advances and future directions |
| title_full | Immunotherapy in gestational trophoblastic neoplasia: advances and future directions |
| title_fullStr | Immunotherapy in gestational trophoblastic neoplasia: advances and future directions |
| title_full_unstemmed | Immunotherapy in gestational trophoblastic neoplasia: advances and future directions |
| title_short | Immunotherapy in gestational trophoblastic neoplasia: advances and future directions |
| title_sort | immunotherapy in gestational trophoblastic neoplasia advances and future directions |
| topic | gestational trophoblastic neoplasia immune checkpoint inhibitors chemoresistance clinical trials fertility preservation immune-related adverse events |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1544585/full |
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