[Current advances and challenges of immunotherapy in gestational trophoblastic neoplasia]

Area of Science:

• Oncology
• Immunology
• Gynecologic Oncology

Background:

• Gestational trophoblastic neoplasia (GTN) comprises rare malignant tumors of trophoblastic tissue.
• GTN is generally curable but poses treatment challenges in high-risk cases, drug resistance, or rare subtypes.

Purpose of the Study:

• To review the current application and controversies of immune checkpoint inhibitors (ICIs) in GTN treatment.
• To propose future research directions and provide references for clinical practice and follow-up studies.

Main Methods:

• Review of existing research findings on immunotherapy in GTN.
• Discussion of biological rationale, clinical application, and unresolved questions regarding ICIs in GTN.

Main Results:

• ICIs, specifically PD-1 and PD-L1 inhibitors, have expanded therapeutic options for recurrent or drug-resistant GTN, achieving long-term remission in some patients.
• GTN exhibits unique immunological features like high antigenicity and immune cell infiltration, supporting immunotherapy's rationale.

Conclusions:

• Immunotherapy, particularly with ICIs, offers new hope for challenging GTN cases.
• Key areas for future research include optimal treatment timing, long-term safety, fertility outcomes, and predictive biomarkers for GTN immunotherapy.