Improving single-agent chemoresistance risk identification in gestational trophoblastic neoplasia
Menée à partir de données portant sur 431 patientes présentant une néoplasie trophoblastique gestationnelle et un score de 5 ou 6 selon le système de classification FIGO, cette étude multicentrique identifie les facteurs prédictifs associés à la résistance à une monothérapie
In The Lancet Oncology, Antonio Braga and colleagues report the results of a multicentre, retrospective study involving the largest cohort of patients with gestational trophoblastic neoplasia presenting with an International Federation of Gynaecology and Obstetrics (FIGO) risk score of 5 or 6, in a low risk setting. Indeed, in so-called low-risk patients (ie, those with stage I or stage II–III disease and a FIGO risk score of 0–6), patients can have heterogeneous outcomes in terms of chemosensitivity to single-agent chemotherapy; in particular, patients with a FIGO risk score of 0–1 have a complete remission rate of 75% compared with approximately 53% in patients with a FIGO risk score of 2–4 and approximately 33% in patients with a FIGO risk score of 5–6. Therefore, whether patients with a FIGO risk score of 5–6 should be treated with a multiagent approach, which is more aggressive than a single-agent approach, is controversial, even though most patients who do not respond to first-line single-agent chemotherapy can have complete remission after second-line single-agent chemotherapy.
The Lancet Oncology , commentaire, 2020