Treatment of metastatic placental site trophoblastic tumor with surgery, chemotherapy, immunotherapy and coil embolization of multiple pulmonary arteriovenous fistulate
| Autor: | R.L. Budker, J.M. Barcelon, X. Aguiar, L. Marsh, Joshua G. Cohen, Ehsan Ghorani, J.M. Moriarty, Baljeet Kaur, J. Rao, Gottfried E. Konecny, Michael J. Seckl, G. Maher, A. Porter |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Placental site trophoblastic tumor medicine.medical_treatment Case Report Pembrolizumab Malignancy Vaccine Related 03 medical and health sciences 0302 clinical medicine Clinical Research medicine Adjuvant therapy RC254-282 Cancer Chemotherapy 030219 obstetrics & reproductive medicine business.industry Tumor-infiltrating lymphocytes fungi Evaluation of treatments and therapeutic interventions Obstetrics and Gynecology food and beverages Neoplasms. Tumors. Oncology. Including cancer and carcinogens Gynecology and obstetrics medicine.disease Tumor Debulking Regimen Oncology 6.1 Pharmaceuticals 030220 oncology & carcinogenesis RG1-991 Immunization Radiology Immunotherapy business |
| Zdroj: | Gynecologic Oncology Reports, Vol 36, Iss, Pp 100782-(2021) Gynecologic Oncology Reports |
| Popis: | Highlights • Placental site trophoblastic tumor can be resistant to chemotherapy. • Multidisciplinary care is required for management of advanced disease. • Increased PD-L1 expression can help guide use of immunotherapies. • Complete responses are possible with aggressive multidisciplinary management. Placental Site Trophoblastic Tumor (PSTT) is a rare malignancy that often presents with extensive disease and can be resistant to traditional treatments. We present the case of a woman with stage IV PSTT who was initially managed with neoadjuvant chemotherapy followed by tumor debulking. Adjuvant therapy was guided by further pathologic analysis that revealed high levels of staining for PD-L1 as well as the presence of tumor infiltrating lymphocytes (TILs). Subsequently, the patient was treated with traditional chemotherapy with the EP/EMA regimen with the addition of pembrolizumab. The patient’s treatment course was complicated by the development of pulmonary arteriovenous malformations, autoimmune thyroiditis thought to be secondary to immunotherapy, and significant tinnitus secondary to platinum agents. Currently the patient is in follow up and remains in a complete remission. |
| Databáze: | OpenAIRE |
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