Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad
Antecedentes: La enfermedad trofoblástica gestacional (ETG) abarca un espectro de condiciones benignas y malignas caracterizadas por una proliferación anormal del trofoblasto. Los avances en la imagenología y en los marcadores bioquímicos han mejorado la detección temprana; sin embargo, persisten de...
- Autores:
-
Hurtado Buendía, Natalia Andrea
- Tipo de recurso:
- https://purl.org/coar/resource_type/c_7a1f
- Fecha de publicación:
- 2025
- Institución:
- Universidad El Bosque
- Repositorio:
- Repositorio U. El Bosque
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.unbosque.edu.co:20.500.12495/13947
- Acceso en línea:
- https://hdl.handle.net/20.500.12495/13947
- Palabra clave:
- Enfermedad trofoblástica gestacional
Neoplasia trofoblástica gestaciona
Inmunoterapia
Preservación de la fertilidad
Inhibidores de puntos de control inmunitario
Gestational trophoblastic disease
Gestational trophoblastic neoplasia
Immunotherapy
fertility preservation
Immune checkpoint inhibitors,
WP 100
- Rights
- License
- Attribution-NonCommercial-ShareAlike 4.0 International
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Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad |
| dc.title.translated.none.fl_str_mv |
gestational trophoblastic disease: a literature review, current evidence on inmunotherapy and infertility |
| title |
Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad |
| spellingShingle |
Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad Enfermedad trofoblástica gestacional Neoplasia trofoblástica gestaciona Inmunoterapia Preservación de la fertilidad Inhibidores de puntos de control inmunitario Gestational trophoblastic disease Gestational trophoblastic neoplasia Immunotherapy fertility preservation Immune checkpoint inhibitors, WP 100 |
| title_short |
Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad |
| title_full |
Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad |
| title_fullStr |
Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad |
| title_full_unstemmed |
Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad |
| title_sort |
Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidad |
| dc.creator.fl_str_mv |
Hurtado Buendía, Natalia Andrea |
| dc.contributor.advisor.none.fl_str_mv |
Montenegro Escobar, Daniel |
| dc.contributor.author.none.fl_str_mv |
Hurtado Buendía, Natalia Andrea |
| dc.subject.none.fl_str_mv |
Enfermedad trofoblástica gestacional Neoplasia trofoblástica gestaciona Inmunoterapia Preservación de la fertilidad Inhibidores de puntos de control inmunitario |
| topic |
Enfermedad trofoblástica gestacional Neoplasia trofoblástica gestaciona Inmunoterapia Preservación de la fertilidad Inhibidores de puntos de control inmunitario Gestational trophoblastic disease Gestational trophoblastic neoplasia Immunotherapy fertility preservation Immune checkpoint inhibitors, WP 100 |
| dc.subject.keywords.none.fl_str_mv |
Gestational trophoblastic disease Gestational trophoblastic neoplasia Immunotherapy fertility preservation Immune checkpoint inhibitors, |
| dc.subject.nlm.none.fl_str_mv |
WP 100 |
| description |
Antecedentes: La enfermedad trofoblástica gestacional (ETG) abarca un espectro de condiciones benignas y malignas caracterizadas por una proliferación anormal del trofoblasto. Los avances en la imagenología y en los marcadores bioquímicos han mejorado la detección temprana; sin embargo, persisten desafíos en el tratamiento, particularmente en casos de quimiorresistencia y neoplasias de alto riesgo. La inmunoterapia ha surgido como una estrategia terapéutica innovadora, aprovechando los inhibidores de puntos de control inmunitarios para potenciar la respuesta antitumoral. Objetivo: Esta revisión de la literatura analiza la evidencia actual sobre el diagnóstico, la clasificación y el tratamiento de la ETG, con especial énfasis en el papel de la inmunoterapia y sus implicaciones en la preservación de la fertilidad. Métodos: Se realizó una revisión exhaustiva de la literatura, examinando las tendencias epidemiológicas, las características histopatológicas y los algoritmos terapéuticos para la ETG y la neoplasia trofoblástica gestacional (NTG). Se prestó especial atención a los estudios que evalúan el papel de los inhibidores de puntos de control inmunitarios, incluyendo pembrolizumab, en la NTG quimiorresistente. Resultados: El tratamiento convencional de la NTG se basa en la quimioterapia, logrando altas tasas de remisión. No obstante, un subgrupo de pacientes desarrolla resistencia, lo que hace necesario explorar terapias alternativas. La inmunoterapia, en particular los agentes anti-PD-1/PD-L1, ha mostrado resultados prometedores en NTG refractaria, con reportes de casos y pequeños ensayos clínicos que evidencian remisión sostenida en pacientes seleccionados. A pesar de su potencial, persisten preocupaciones sobre su impacto en la preservación de la fertilidad, ya que la modulación inmunitaria podría afectar los resultados reproductivos. Conclusiones: La inmunoterapia representa una vía terapéutica prometedora para la NTG, especialmente en casos de quimiorresistencia. Sin embargo, se requieren más ensayos clínicos para establecer su eficacia, optimizar los protocolos de tratamiento y evaluar sus efectos a largo plazo en la fertilidad. A medida que evoluciona el manejo de la ETG, será fundamental un enfoque multidisciplinario que integre oncología, medicina reproductiva e inmunología para mejorar los desenlaces clínicos. Palabras clave: enfermedad trofoblástica gestacional, neoplasia trofoblástica gestacional, inmunoterapia, inhibidores de puntos de control inmunitario, preservación de la fertilidad, pembrolizumab. |
| publishDate |
2025 |
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2025-02-13T20:10:12Z |
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2025-02-13T20:10:12Z |
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2025-01 |
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Tesis/Trabajo de grado - Monografía - Especialización |
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Wang X, Wu J, Xie W. Evolution of Treatment Strategies for Gestational Trophoblastic Neoplasia: Chemotherapy, Immunotherapy, and Molecular Targeted Therapy. Current Treatment Options in Oncology. 2024;25(8):1055–62. Vélez-Bohórquez M, Olaya-Contreras M, Vélez Bohórquez M. Enfermedad trofoblástica gestacional. Revisión de la bibliografía Gestacional trofoblastic disease. Literature review. Patología. 2022;60:1–11. Nayak B, Singh U. Gestational Trophoblastic Disease: Benign to Malignant. Gestational Trophoblastic Disease: Benign to Malignant. 2021. 1–162 p. Knöfler M, Pollheimer J. Human placental trophoblast invasion and differentiation: A particular focus on Wnt signaling. Frontiers in Genetics. 2013;4(SEP):1–14. Coronado PJ, Marquina G, Diestro M, Alonso S, Sánchez del Río A, Hardisson D, et al. Guía de Asistencia Práctica. Enfermedad trofoblástica gestacional. Revista Oficial de la Sociedad Española de Ginecología y Obstetricia-. Revista Oficial de la Sociedad Española de Ginecología y Obstetricia. 2020;63(3):165–84. Horowitz NS, Eskander RN, Adelman MR, Burke W. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecologic Oncology. 2021;163(3):605–13. Savage PM, Sita-Lumsden A, Dickson S, Iyer R, Everard J, Coleman R, et al. The relationship of maternal age to molar pregnancy incidence, risks for chemotherapy and subsequent pregnancy outcome. Journal of Obstetrics and Gynaecology. 2013;33(4):406–11. Vencken PMLH, Ewing PC, Zweemer RP. Epithelioid trophoblastic tumour: a case report and review of the literature. Journal of Clinical Pathology. 2006 Apr 27;59(12):1307–8. Bogani G, Ray-Coquard I, Mutch D, Vergote I, Ramirez PT, Prat J, et al. Gestational choriocarcinoma. International Journal of Gynecological Cancer. 2023;33(10):1504–14. Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Diagnosis and management of gestational trophoblastic disease: 2021 update. International Journal of Gynecology and Obstetrics. 2021;155(S1):86–93. Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Update on the diagnosis and management of gestational trophoblastic disease. International Journal of Gynecology & Obstetrics. 2018 Oct;143:79–85. Davick JJ. Placental and Gestational Pathology. American Journal of Surgical Pathology. 2019;43(5):724–724. Kaur B. Pathology of gestational trophoblastic disease (GTD). Best Practice and Research: Clinical Obstetrics and Gynaecology. 2021;74(2021):3–28. Kaur B, Short D, Fisher RA, Savage PM, Seckl MJ, Sebire NJ. Atypical Placental Site Nodule (APSN) and Association With Malignant Gestational Trophoblastic Disease; A Clinicopathologic Study of 21 Cases. International Journal of Gynecological Pathology. 2015 Mar;34(2):152–8. Lurain JR. Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia. American journal of obstetrics and gynecology. 2011 Jan;204(1):11–8. Bolze P, Provost M, Massardier J, Hajri T, Descargues P, Msika A, et al. Enfermedades trofoblásticas gestacionales : molas hidatiformes. 2024;60(24):1–13. Goldstein DP, Berkowitz RS. Current management of gestational trophoblastic neoplasia. Hematology/oncology clinics of North America. 2012 Feb;26(1):111–31. Lok C, Frijstein M, van Trommel N. Clinical presentation and diagnosis of Gestational Trophoblastic Disease. Best Practice & Research Clinical Obstetrics & Gynaecology. 2021 Jul;74(xxxx):42–52. Froeling FEM, Seckl MJ. Gestational Trophoblastic Tumours: An Update for 2014. Current Oncology Reports. 2014 Nov 16;16(11):408. Lukinovic N, Malovrh EP, Takac I, Sobocan M, Knez J. Advances in diagnostics and management of gestational trophoblastic disease. Radiology and Oncology. 2022;56(4):430–9. Jauniaux E, Memtsa M, Johns J, Ross JA, Jurkovic D. New insights in the pathophysiology of complete hydatidiform mole. Placenta. 2018;62:28–33. Chawla T, Bouchard-Fortier G, Turashvili G, Osborne R, Hack K, Glanc P. Gestational trophoblastic disease: an update. Abdominal Radiology. 2023;48(5):1793–815. Seckl MJ, Sebire NJ, Fisher RA, Golfier F, Massuger L, Sessa C. Gestational trophoblastic disease: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2013;24(SUPPL.6). Strickland AL, Gwin K. Gestational trophoblastic disease- rare, sometimes dramatic, and what we know so far. Seminars in Diagnostic Pathology. 2022;39(3):228–37. Greene DN, Grenache DG. Pathology consultation on human chorionic gonadotropin testing for pregnancy assessment. American Journal of Clinical Pathology. 2015;144(6):830–6. Hernández-Gallo PD, García- Aguilar JR, Galaviz de Anda JM. Enfermedad Trofoblástica Gestacional. Lux Médica. 2011 Sep 30;6(19):27–34. Deleuze A, Massard C, Le Du F, You B, Lefeuvre-Plesse C, Bolze PA, et al. Management of trophoblastic tumors : review of evidence, current practice, and future directions. Expert Review of Anticancer Therapy. 2023 Jul 3;23(7):699–708. Abu-Rustum NR, Yashar CM, Bean S, Bradley K, Campos SM, Chon HS, et al. Gestational Trophoblastic Neoplasia, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network. 2019 Nov 29;17(11):1374–91. Shahzadi M, Khan SR, Tariq M, Baloch SS, Shahid A, Moosajee M, et al. Review of current literature on gestational trophoblastic neoplasia. Journal of the Egyptian National Cancer Institute. 2023;35(1):4–9. Joyce CM, Fitzgerald B, McCarthy T V, Coulter J, O’Donoghue K. Advances in the diagnosis and early management of gestational trophoblastic disease. BMJ Medicine. 2022 Dec;1(1):e000321. Clark JJ, Slater S, Seckl MJ. Treatment of gestational trophoblastic disease in the 2020s. Current Opinion in Obstetrics and Gynecology. 2021;33(1):7–12. Soper JT. Gestational Trophoblastic Disease: Current Evaluation and Management. Obstetrics and gynecology. 2021 Feb 1;137(2):355–70. Lawrie TA, Alazzam M, Tidy J, Hancock BW, Osborne R. First-line chemotherapy in low-risk gestational trophoblastic neoplasia. Cochrane Database of Systematic Reviews. 2016;2016(6). Li L, Wan X, Feng F, Ren T, Yang J, Zhao J, et al. Pulse actinomycin D as first-line treatment of low-risk post-molar non-choriocarcinoma gestational trophoblastic neoplasia. BMC Cancer. 2018;18(1):6–11. Durón-González R, Bolaños-Morera P. Enfermedad Trofoblastica Gestacional G. Medicina Legal de Costa Rica Edición Virtual. 2018;35(1):1–14. Braga A, Elias KM, Horowitz NS, Berkowitz RS. Treatment of high-risk gestational trophoblastic neoplasia and chemoresistance/relapsed disease. Best Practice and Research: Clinical Obstetrics and Gynaecology. 2021;74(xxxx):81–96. Braga A, Paiva G, Cattai CJ, Elias KM, Horowitz NS, Berkowitz RS. Current chemotherapeutic options for the treatment of gestational trophoblastic disease. Expert Opinion on Pharmacotherapy. 2023 Jan 22;24(2):245–58. Baas IO, Westermann AM, You B, Bolze PA, Seckl M, Ghorani E. Immunotherapy for Gestational Trophoblastic Neoplasia: A New Paradigm. Gynecologic and Obstetric Investigation. 2023;1–9. Ghorani E, Kaur B, Fisher RA, Short D, Joneborg U, Carlson JW, et al. Pembrolizumab is effective for drug-resistant gestational trophoblastic neoplasia. The Lancet. 2017;390(10110):2343–5. Alazzam M, Tidy J, Osborne R, Coleman R, Hancock BW, Lawrie TA. Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia. Cochrane Database of Systematic Reviews. 2016;2016(1). Zitvogel L, Kroemer G. Targeting PD-1/PD-L1 interactions for cancer immunotherapy. OncoImmunology. 2012;1(8):1223–5. Garutti M, Lambertini M, Puglisi F. Checkpoint inhibitors, fertility, pregnancy, and sexual life: a systematic review. ESMO Open. 2021 Oct;6(5):100276. Kim AE, Nelson A, Stimpert K, Flyckt RL, Thirumavalavan N, Baker KC, et al. Minding the Bathwater: Fertility and Reproductive Toxicity in the Age of Immuno-Oncology. JCO Oncology Practice. 2022;18(12):815–22. Li X, Li ZH, Wang YX, Liu TH. A comprehensive review of human trophoblast fusion models: recent developments and challenges. Cell Death Discovery. 2023;9(1):1–14. Wang T, Guo W, Ren X, Lang F, Ma Y, Qiu C, et al. Progress of immunotherapies in gestational trophoblastic neoplasms. Journal of Cancer Research and Clinical Oncology. 2023;149(16):15275–85. Alard E, Butnariu AB, Grillo M, Kirkham C, Zinovkin DA, Newnham L, et al. Advances in anti-cancer immunotherapy: Car-t cell, checkpoint inhibitors, dendritic cell vaccines, and oncolytic viruses, and emerging cellular and molecular targets. Cancers. 2020;12(7):1–38. Goldfarb JA, Dinoi G, Mariani A, Langstraat CL. A case of multi-agent drug resistant choriocarcinoma treated with Pembrolizumab. Gynecologic Oncology Reports. 2020;32(April):100574. Clair KH, Gallegos N, Bristow RE. Successful treatment of metastatic refractory gestational choriocarcinoma with pembrolizumab: A case for immune checkpoint salvage therapy in trophoblastic tumors. Gynecologic Oncology Reports. 2020;34(August):100625. Huang M, Pinto A, Castillo RP, Slomovitz BM. Complete serologic response to pembrolizumab in a woman with chemoresistant metastatic choriocarcinoma. Journal of Clinical Oncology. 2017;35(27):3172–4. Mrcp EG, Frcpath BK, Fisher RA, Short D, Phd UJ, Carlson JW, et al. Pembrolizumab induces long term complete remission in patients with chemotherapy resistant gestational trophoblastic neoplasia despite classical HLA deficiency. 44(0):1–16. Choi MC, Oh J, Lee C. Effective anti-programmed cell death 1 treatment for chemoresistant gestational trophoblastic neoplasia. European Journal of Cancer. 2019;121:94–7. Goldfarb JA, Dinoi G, Mariani A, Langstraat CL. A case of multi-agent drug resistant choriocarcinoma treated with Pembrolizumab. Gynecologic Oncology Reports. 2020;32(March):100574. Pisani D, Calleja-Agius J, Di Fiore R, O’Leary JJ, Beirne JP, O’Toole SA, et al. Epithelioid trophoblastic tumour: A case with genetic linkage to a child born over seventeen years prior, successfully treated with surgery and pembrolizumab. Current Oncology. 2021;28(6):5346–55. Bell SG, Uppal S, Sakala MD, Sciallis AP, Rolston A. An extrauterine extensively metastatic epithelioid trophoblastic tumor responsive to pembrolizumab. Gynecologic Oncology Reports. 2021;37(June):100819. Paspalj V, Polterauer S, Poetsch N, Reinthaller A, Grimm C, Bartl T. Long-term survival in multiresistant metastatic choriocarcinoma after pembrolizumab treatment: A case report. Gynecologic Oncology Reports. 2021;37:100817. Mangili G, Sabetta G, Cioffi R, Rabaiotti E, Candotti G, Pella F, et al. Current Evidence on Immunotherapy for Gestational Trophoblastic Neoplasia (GTN). Cancers. 2022;14(11):1–13. You B, Bolze PA, Lotz JP, Massardier J, Gladieff L, Floquet A, et al. Avelumab in patients with gestational trophoblastic tumors with resistance to polychemotherapy: Cohort B of the TROPHIMMUN phase 2 trial. Gynecologic Oncology. 2023;168(2023):62–7. You B, Bolze PA, Lotz JP, Massardier J, Gladieff L, Joly F, et al. Avelumab in patients with gestational trophoblastic tumors with resistance to single-agent chemotherapy: Cohort a of the TROPHIMMUN phase II trial. Journal of Clinical Oncology. 2020;38(27):3129–37. Paydas S. Immune checkpoint inhibitor using in cases with gestational trophoblastic diseases. Medical Oncology. 2023;40(3):1–11. Zhang P, Wang Y, Miao Q, Chen Y. The therapeutic potential of PD-1/PD-L1 pathway on immune-related diseases: Based on the innate and adaptive immune components. Biomedicine and Pharmacotherapy. 2023;167(July):115569. Polnaszek B, Mullen M, Bligard K, Raghuraman N, Massad LS. Term Pregnancy After Complete Response of Placental Site Trophoblastic Tumor to Immunotherapy. Obstetrics and Gynecology. 2021;138(1):115–8. Joneborg U, Coopmans L, van Trommel N, Seckl M, Lok CAR. Fertility and pregnancy outcome in gestational trophoblastic disease. International Journal of Gynecologic Cancer. 2021 Mar 1;31(3):399–411. Duma N, Lambertini M. It Is Time to Talk About Fertility and Immunotherapy. The Oncologist. 2020 Apr 1;25(4):277–8. Hennah L, Seckl M, Ghorani E. Novel approaches to managing gestational trophoblastic tumors in the age of immunotherapy. International Journal of Gynecologic Cancer. 2023 Mar 6;33(3):414–9. Vargas R, Barroilhet LM, Esselen K, Diver E, Bernstein M, Goldstein DP, et al. Subsequent pregnancy outcomes after complete and partial molar pregnancy, recurrent molar pregnancy, and gestational trophoblastic neoplasia: an update from the New England Trophoblastic Disease Center. The Journal of reproductive medicine. 2014;59(5–6):188–94. Angiolo Gadducci NL, Cosio S. Reproductive outcomes after hydatiform mole and gestational trophoblastic neoplasia. Gynecological Endocrinology. 2015;31(9):673–8. |
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Montenegro Escobar, DanielHurtado Buendía, Natalia Andrea2025-02-13T20:10:12Z2025-02-13T20:10:12Z2025-01https://hdl.handle.net/20.500.12495/13947instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coAntecedentes: La enfermedad trofoblástica gestacional (ETG) abarca un espectro de condiciones benignas y malignas caracterizadas por una proliferación anormal del trofoblasto. Los avances en la imagenología y en los marcadores bioquímicos han mejorado la detección temprana; sin embargo, persisten desafíos en el tratamiento, particularmente en casos de quimiorresistencia y neoplasias de alto riesgo. La inmunoterapia ha surgido como una estrategia terapéutica innovadora, aprovechando los inhibidores de puntos de control inmunitarios para potenciar la respuesta antitumoral. Objetivo: Esta revisión de la literatura analiza la evidencia actual sobre el diagnóstico, la clasificación y el tratamiento de la ETG, con especial énfasis en el papel de la inmunoterapia y sus implicaciones en la preservación de la fertilidad. Métodos: Se realizó una revisión exhaustiva de la literatura, examinando las tendencias epidemiológicas, las características histopatológicas y los algoritmos terapéuticos para la ETG y la neoplasia trofoblástica gestacional (NTG). Se prestó especial atención a los estudios que evalúan el papel de los inhibidores de puntos de control inmunitarios, incluyendo pembrolizumab, en la NTG quimiorresistente. Resultados: El tratamiento convencional de la NTG se basa en la quimioterapia, logrando altas tasas de remisión. No obstante, un subgrupo de pacientes desarrolla resistencia, lo que hace necesario explorar terapias alternativas. La inmunoterapia, en particular los agentes anti-PD-1/PD-L1, ha mostrado resultados prometedores en NTG refractaria, con reportes de casos y pequeños ensayos clínicos que evidencian remisión sostenida en pacientes seleccionados. A pesar de su potencial, persisten preocupaciones sobre su impacto en la preservación de la fertilidad, ya que la modulación inmunitaria podría afectar los resultados reproductivos. Conclusiones: La inmunoterapia representa una vía terapéutica prometedora para la NTG, especialmente en casos de quimiorresistencia. Sin embargo, se requieren más ensayos clínicos para establecer su eficacia, optimizar los protocolos de tratamiento y evaluar sus efectos a largo plazo en la fertilidad. A medida que evoluciona el manejo de la ETG, será fundamental un enfoque multidisciplinario que integre oncología, medicina reproductiva e inmunología para mejorar los desenlaces clínicos. Palabras clave: enfermedad trofoblástica gestacional, neoplasia trofoblástica gestacional, inmunoterapia, inhibidores de puntos de control inmunitario, preservación de la fertilidad, pembrolizumab.Especialista en Ginecología y ObstetriciaEspecializaciónBackground: Gestational trophoblastic disease (GTD) encompasses a spectrum of benign and malignant conditions arising from abnormal trophoblastic proliferation. Advances in imaging and biochemical markers have improved early detection, yet treatment challenges persist, particularly in cases of chemoresistance and high-risk neoplasia. Immunotherapy has emerged as a novel therapeutic approach, leveraging immune checkpoint inhibitors to enhance antitumor responses. Objective: This literature review examines current evidence on the diagnosis, classification, and treatment of GTD, with a special focus on immunotherapy and its implications for fertility preservation. Methods: A comprehensive review of the literature was conducted, analyzing epidemiological trends, histopathological characteristics, and treatment algorithms for GTD and gestational trophoblastic neoplasia (GTN). Special attention was given to studies evaluating the role of immune checkpoint inhibitors, including pembrolizumab, in chemoresistant GTN. Results: Traditional GTN treatment relies on chemotherapy, achieving high remission rates. However, a subset of patients develops resistance, necessitating alternative therapies. Immunotherapy, particularly anti-PD-1/PD-L1 agents, has shown promising results in refractory GTN, with case reports and small clinical trials demonstrating sustained remission in selected patients. Despite its potential, concerns regarding fertility preservation remain, as immune modulation may impact reproductive outcomes. Conclusions: Immunotherapy represents a promising therapeutic avenue for GTN, particularly in chemoresistant cases. However, further clinical trials are needed to establish efficacy, optimize treatment protocols, and assess long-term effects on fertility. As the landscape of GTD treatment evolves, multidisciplinary approaches integrating oncology, reproductive medicine, and immunology will be essential to improve patient outcomes. Keywords: gestational trophoblastic disease, gestational trophoblastic neoplasia, immunotherapy, immune checkpoint inhibitors, fertility preservation, pembrolizumabapplication/pdfAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-sa/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2Enfermedad trofoblástica gestacionalNeoplasia trofoblástica gestacionaInmunoterapiaPreservación de la fertilidadInhibidores de puntos de control inmunitarioGestational trophoblastic diseaseGestational trophoblastic neoplasiaImmunotherapyfertility preservationImmune checkpoint inhibitors,WP 100Enfermedad trofoblástica gestacional: revisión de la literatura y evidencia actual en inmunoterapia e infertilidadgestational trophoblastic disease: a literature review, current evidence on inmunotherapy and infertilityEspecialización en Ginecología y ObstetriciaUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aaWang X, Wu J, Xie W. 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Gynecological Endocrinology. 2015;31(9):673–8.spaLICENSElicense.txtlicense.txttext/plain; charset=utf-82000https://repositorio.unbosque.edu.co/bitstreams/ab4a6219-9575-4717-8f48-fce47938123f/download17cc15b951e7cc6b3728a574117320f9MD52Carta de autorizacion1.pdfapplication/pdf308534https://repositorio.unbosque.edu.co/bitstreams/82418e39-2fc1-4769-8e14-c1a66a0c57ee/download62826957dddffe09b69bfc09a79924efMD55Anexo 1 Acta de aprobacion.pdfapplication/pdf1163360https://repositorio.unbosque.edu.co/bitstreams/3b1bb8d5-10a7-487d-b530-18c40ae457d4/download81588e4b4dbc3f7226b570eb1c4f69beMD56ORIGINALTrabajo de grado.pdfTrabajo de grado.pdfapplication/pdf2521859https://repositorio.unbosque.edu.co/bitstreams/36e9ae70-86da-43d2-93f2-318bbcc9ed0f/downloadfa3dd485d311fd58de480f27369ce129MD53CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81160https://repositorio.unbosque.edu.co/bitstreams/450307ed-f1b3-4c20-904e-6c79b17caeee/download5643bfd9bcf29d560eeec56d584edaa9MD54TEXTTrabajo de grado.pdf.txtTrabajo de grado.pdf.txtExtracted texttext/plain103119https://repositorio.unbosque.edu.co/bitstreams/60ebb618-8077-4744-8af0-b7e699825c75/download9e9589d4264fe38852337102c74d8564MD57THUMBNAILTrabajo de grado.pdf.jpgTrabajo de grado.pdf.jpgGenerated Thumbnailimage/jpeg2953https://repositorio.unbosque.edu.co/bitstreams/e3eb12b6-d48f-4640-a3b3-c5ca030f0acb/download679768da80756e4c8682a4c8e871fd11MD5820.500.12495/13947oai:repositorio.unbosque.edu.co:20.500.12495/139472025-02-14 03:06:56.691http://creativecommons.org/licenses/by-nc-sa/4.0/Attribution-NonCommercial-ShareAlike 4.0 Internationalopen.accesshttps://repositorio.unbosque.edu.coRepositorio Institucional Universidad El Bosquebibliotecas@biteca.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 |