Pharmacotherapy of placental site and epithelioid trophoblastic tumours

Abstract

Introduction: Placental site and epithelioid trophoblastic tumours (PSTT/ETT) are rare subtypes of gestational trophoblastic neoplasia (GTN). The diagnosis and treatment of these tumours pose challenges to physicians due to their rarity and relative resistance to chemotherapy. No clinical trials have been carried out in this subset. Evidence for best treatment is derived from retrospective case series/reports and extrapolated from the management of patients with other forms of GTN.

Areas covered: The surgical and pharmacological management of PSTT and ETT are reviewed. In addition, prognostic factors are discussed because they aid the risk stratification of patients to ensure optimal management, while minimising potential detrimental side effects. PubMed and Cochrane databases were searched using the keywords ‘placental site trophoblastic tumour’ and ‘epithelioid trophoblastic tumour’.

Expert opinion: Surgery is a vital part of the management of PSTT and ETT. Surgery alone will not cure advanced disease and a multi-modality therapeutic approach with combination chemotherapy is recommended. The rarity of PSTT and ETT leads to difficulties in defining optimal chemotherapy regimens. All patients with PSTT or ETT should be managed at a centre with expertise in GTN. International collaboration is vital to improve understanding of these rare disorders and to enable the standardisation of treatments.

Keywords:

• chemotherapy
• epithelioid trophoblastic tumour
• gestational trophoblastic neoplasia
• placental site trophoblastic tumour
• surgery

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents, received or pending, or royalties.

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