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After four years of study, the Hospices Civils de Lyon have validated a new treatment to treat a little-known form of pregnancy cancer, called gestational trophoblastic tumors, with an “extremely rare success rate.”
The figure is unexpected in medicine. On Saturday, September 14, during the annual congress of the European Society of Medical Oncology in Barcelona, the National Reference Center for Trophoblastic Diseases of the Hospices Civils de Lyon (HCL) presented a new treatment against a form of pregnancy cancer, gestational trophoblastic tumors.. This would have worked on 25 out of 26 patients, thus offering a cure rate of 96%. Almost flawless.
What are gestational trophoblastic tumors?
According to the HCL website, gestational trophoblastic diseases constitute “a broad spectrum of tumor pathologies derived from placental tissue.” The most common form (1 pregnancy per 1000 in France) is the hydatidiform mole. “It is initially benign and resembles an early pregnancy, but the embryo does not develop, only the placenta proliferates.”
In 20% of cases, however, it transforms into a so-called “low risk” gestational trophoblastic tumor (GTT), often metastatic and potentially fatal.Between 100 and 200 patients per year, with an average of 130, are concerned.” explains Professor Benoit You, oncologist at the Hospices Civils de Lyon.
Combining immunotherapy and chemotherapy could eradicate the disease
For 4 years, Professors Benoît You and Pierre-Adrien Bolze, respectively oncologist and gynecological surgeon, have decided to launch TROPHAMET, a clinical trial combining immunotherapy and chemotherapy (methotrexate) in order to treat the category of gestational trophoblastic tumors (GTT) at “low risk”.
“We conducted a first Trophimmun study that was published in 2021, and which demonstrated that avelumab could cure approximately 50% of patients who had resistance to chemotherapy. So, the next logical step was to combine it, right from the start, with first-line chemotherapy, without waiting for patients to develop resistance.” Professor Benoit You tells us.
The cleverly designed dual therapy set up for each patient involves an injection of methotrexate every other day for a week, repeated in this way every two weeks, and, on the first day of chemo, an injection of avelumab (every two weeks, therefore). Then, the level of hCG (human chorionic gonadotropin, produced during pregnancy) is monitored every week.As long as this hormone is present at abnormal levels, this indicates that the disease is active. As soon as the level returns to normal, we start again with three final treatments, i.e. six weeks, then we stop all treatments.“, describes Professor Jean Pierre Lotz, head of the Parisian research center (Tenon Hospital, APHP).
The last phase of their trial thus made it possible to treat 25 out of 26 patients.
“Since we knew that the resistance rate under chemotherapy alone was 70%, we had hypothesized that the combination could cure more than 90%. The good news is that we have far exceeded this hypothesis.“e” enthuses Professor Benoit You.
The cure rate is approaching 100%, a proportion rarely achieved in the history of cancer research of any kind. “This is an exceptional result (…) It is one of the first times that we are talking about the eradication of cancer” announces the official press release.
Access to the drug will take time
Excellent news, and a promising treatment, but which will still need a little time to be accessible. The study will not be published until 2025. Contacted by Doctissimo, Professor Benoit You, however, hopes to be able to speed things up: “From an ethical point of view, we want to offer it to patients as soon as possible. But the drug has neither marketing authorisation in this situation nor reimbursement. In the short term, we hope to be able to prescribe on a compassionate basis, with the support of the pharmaceutical company. In the medium term, we will try to take steps with the European and French health authorities so that the drug is made available to patients in routine care.“.