Combined chemotherapy and pembrolizumab salvages multi-chemotherapy agent and avelumab resistant choriocarcinoma: A case report

• DOI: 10.1016/j.gore.2023.101259
• Publication Date: 2023-08-12T21:01:15Z
• Authors: M. Lehmann; H. Hosa; T. Bartl; I. Tsibulak; S. Polterauer; N. Pötsch; M.J. Seckl; C. Marth
• Keywords: 03 medical and health sciences; Survey Article; 0302 clinical medicine; RG1-991; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; Gynecology and obstetrics; RC254-282

Gestational trophoblastic neoplasia (GTN) including choriocarcinoma (CC) frequently requires multi-agent chemotherapy to achieve cure. In chemotherapy-resistant GTN, immunotherapy with the checkpoint inhibitors pembrolizumab, avelumab and camrelizumab are potential new treatment options previously described in small case series, phase 2 trials reports.A 32-year-old woman was diagnosed gestational (FIGO score 5). Prior administered therapy regimes included methotrexate, actinomycin-D followed by open hysterectomy bilateral salpingectomy (histology without GTN) as well single-agent. After detection of a suspicious pulmonary mass video- assisted thoracoscopic left lung segmentectomy performed confirming CC. The patient experienced an intracerebral haemorrhage treated emergency decompressive craniotomy. cerebrospinal fluid showed increased ratio hCG compared serum. Therapy combined escalated etoposide cisplatin pembrolizumab commenced maintenance achieving complete response negative PET CT.In management multi drug- resistant application inhibitor is therapeutic strategy. this heavily pre-treated incorporation resulted long-term who had also failed therapy.