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Cancers
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Advances in Treatment of Rare Tumors
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Advances in Treatment of Rare Tumors

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (20 September 2021) | Viewed by 7914

Special Issue Editors

Dr. Giorgia Mangili

E-Mail Website
Guest Editor
Unit of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy
Interests: gynecologic oncology; fertility preservation; chemotherapy
Special Issues, Collections and Topics in MDPI journals
Dr. Alice Bergamini

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Ospedale San Rafaele, 20132 Milan, Italy
Interests: gynecologic oncology; rare tumors; gestational trophoblastic disease; treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gestational trophoblastic disease (GTD) is a rare entity comprising several pregnancy-related tumor subtypes, ranging from premalignant to malignant disease (commonly referred to as “gestational trophoblastic neoplasia”, GTN). Given its rarity, management and treatment can be difficult. Since the introduction of platinum-based chemotherapy, the prognosis of patients affected by GTN has dramatically improved. However, chemotherapy-resistant disease still represents a major challenge. In recent years, new, promising strategies in treatment have emerged. The aim of this Special Issue is to give an updated insight into this topic, with a particular focus on future perspectives for the treatment of GTN.

Dr. Giorgia Mangili
Dr. Alice Bergamini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gestational trophoblastic neoplasia
  • placental site trophoblastic tumor
  • choriocarcinoma
  • epithelioid trophoblastic tumor
  • immunotherapy

Published Papers (3 papers)

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Research

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11 pages, 687 KiB  
Article
Differences in Administration of Methotrexate and Impact on Outcome in Low-Risk Gestational Trophoblastic Neoplasia
by Emelie Wallin, Isa Niemann, Louise Faaborg, Lars Fokdal and Ulrika Joneborg
Cancers 2022, 14(3), 852; https://doi.org/10.3390/cancers14030852 - 8 Feb 2022
Cited by 1 | Viewed by 2502
Abstract
Methotrexate (MTX) is frequently used as first-line treatment for low-risk gestational trophoblastic neoplasia (GTN). Intravenous and intramuscular (im) routes of administration are the most common methods, although oral administration is used by some Scandinavian centers. The primary aim of this study was to [...] Read more.
Methotrexate (MTX) is frequently used as first-line treatment for low-risk gestational trophoblastic neoplasia (GTN). Intravenous and intramuscular (im) routes of administration are the most common methods, although oral administration is used by some Scandinavian centers. The primary aim of this study was to assess the impact of form of administration (im/oral) on resistance to methotrexate (MTX-R) treatment in low-risk GTN. Secondary aims were time to hCG normalization, rates of toxicity-induced treatment switch, and rates of complete remission and recurrence. In total, 170 women treated at Karolinska University Hospital in Sweden and Aarhus University Hospital in Denmark between 1994 and 2018 were included, of whom 107 were given im and 63 oral MTX. MTX-R developed in 35% and 54% in the im and oral groups, respectively (p = 0.01). There was no difference in days to hCG normalization (42 vs. 41 days, p = 0.50) for MTX-sensitive women. Toxicity-induced treatment switch was only seen in the im group. Complete remission was obtained in 99.1% and 100% (p = 0.44), and recurrence rate within one year was 2.8% and 1.6% (p = 0.29). The form of administration of MTX had a significant impact on development of MTX-R and treatment-associated toxicity, but does not affect rates of complete remission, recurrence or survival. Full article
(This article belongs to the Special Issue Advances in Treatment of Rare Tumors)
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Review

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16 pages, 842 KiB  
Review
Radiation Therapy for Gestational Trophoblastic Neoplasia: Forward-Looking Lessons Learnt
by Amelia Barcellini, Andrei Fodor, Alexandra Charalampopoulou, Chiara Cassani, Laura Deborah Locati, Raffaella Cioffi, Alice Bergamini, Sandro Pignata, Ester Orlandi and Giorgia Mangili
Cancers 2023, 15(19), 4817; https://doi.org/10.3390/cancers15194817 - 30 Sep 2023
Viewed by 937
Abstract
Gestational trophoblastic neoplasia (GTN) includes several rare malignant diseases occurring after pregnancy: invasive moles, choriocarcinoma, placental site trophoblastic tumours, and epithelioid trophoblastic tumours. Multidisciplinary protocols including multi-agent chemotherapy, surgery, and occasionally radiotherapy achieve good outcomes for some high-risk metastatic patients. In this narrative [...] Read more.
Gestational trophoblastic neoplasia (GTN) includes several rare malignant diseases occurring after pregnancy: invasive moles, choriocarcinoma, placental site trophoblastic tumours, and epithelioid trophoblastic tumours. Multidisciplinary protocols including multi-agent chemotherapy, surgery, and occasionally radiotherapy achieve good outcomes for some high-risk metastatic patients. In this narrative review of the published studies on the topic, we have tried to identify the role of radiotherapy. The available studies are mainly small, old, and retrospective, with incomplete data regarding radiotherapy protocols delivering low doses (which can make this disease appear radioresistant in some cases despite high response rates with palliative doses) to wide fields (whole-brain, whole-liver, etc.), which can increase toxicity. Studies considering modern techniques are needed to overcome these limitations and determine the full potential of radiotherapy beyond its antihemorrhagic and palliative roles. Full article
(This article belongs to the Special Issue Advances in Treatment of Rare Tumors)
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13 pages, 619 KiB  
Review
Current Evidence on Immunotherapy for Gestational Trophoblastic Neoplasia (GTN)
by Giorgia Mangili, Giulia Sabetta, Raffaella Cioffi, Emanuela Rabaiotti, Giorgio Candotti, Francesca Pella, Massimo Candiani and Alice Bergamini
Cancers 2022, 14(11), 2782; https://doi.org/10.3390/cancers14112782 - 3 Jun 2022
Cited by 12 | Viewed by 3447
Abstract
Background: Gestational trophoblastic disease includes a rare group of benign and malignant tumors derived from abnormal trophoblastic proliferation. Malignant forms are called gestational trophoblastic neoplasia (GTN) and include invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. Standard treatment of GTN [...] Read more.
Background: Gestational trophoblastic disease includes a rare group of benign and malignant tumors derived from abnormal trophoblastic proliferation. Malignant forms are called gestational trophoblastic neoplasia (GTN) and include invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. Standard treatment of GTN is chemotherapy. The regimen of choice mainly depends on the FIGO prognostic score. Low-risk and high-risk GTN is treated with single-agent or multiagent chemotherapy, respectively. In the case of chemoresistance, immunotherapy may represent a new therapeutic strategy. Methods: Literature obtained from searches on PubMed concerning GTN and immunotherapy was reviewed. Results: Programmed cell death 1 (PD-1) and its ligands (PD-L1/2) are expressed in GTN. Published data on PD-1/PD-L1 inhibitors alone in GTN were available for 51 patients. Pembrolizumab is an anti-PD-1 inhibitor used in chemoresistant forms of GTN. In the TROPHIMMUN trial, Avelumab, a monoclonal antibody inhibiting PD-L1, showed promising results only in patients with GTN resistant to monochemotherapy. Conversely, in patients with resistance to multiagent chemotherapy, treatment with Avelumab was discontinued due to severe toxicity and disease progression. The association of Camrelizumab and Apatinib could represent a different treatment for forms of GTN refractory to polychemotherapy or for relapses. Conclusions: Anti-PD-1 or anti-PD-L1 might represent an important new treatment strategy for the management of chemoresistant/refractory GTN. Full article
(This article belongs to the Special Issue Advances in Treatment of Rare Tumors)
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