{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:48:08Z","timestamp":1793152088088,"version":"4.5.0"},"reference-count":31,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"\n Importance<\/jats:title>\n Low-risk gestational trophoblastic tumors (GTT; International Federation of Gynecology and Obstetrics [FIGO] score \u22646) are typically treated with single-agent chemotherapy, achieving cure rates of approximately 70%. Avelumab (anti\u2013programmed cell death 1 ligand 1 monoclonal antibody) has demonstrated activity in chemotherapy-resistant GTT, supporting investigation in earlier treatment settings.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the safety and efficacy of avelumab combined with methotrexate as first-line therapy in patients with low-risk GTT.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n TROPHAMET (Avelumab and Methotrexate in Low-Risk Gestational Trophoblastic Neoplasias as First-Line Treatment) was a multicenter, phase 1\/2 nonrandomized clinical trial of patients with low-risk GTT (FIGO score \u22646) treated at academic referral centers. The study period was from April 14, 2020, to December 5, 2023, with a follow-up of 41 months. Data were analyzed from December 20, 2024, to July 3, 2025.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Avelumab, 800 mg, intravenously on day 1 plus methotrexate, 1 mg\/kg, intramuscularly on days 1, 3, 5, and 7 alternating with oral folinic acid in 2-week cycles until normalization of human chorionic gonadotropin (hCG) level; and followed by 3 consolidation cycles.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Phase 1 primary end point was dose-limiting toxic effects (DLTs); phase 2 primary end point was the rate of serum hCG normalization permitting treatment discontinuation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 27 female patients treated (median [range] age, 35 [20-50] years), 26 were assessable for efficacy. Eight patients (31%) had FIGO scores of 1 to 2; 8 patients (31%) had scores of 3 to 4; and 10 patients (38%) had scores of 5 to 6. The treatment regimen demonstrated acceptable safety: 1 DLT occurred (grade 3 sepsis on central venous catheter); immune- and treatment-related adverse events of grade 2 or higher occurred in 6 patients (22%), all of which fully resolved except for 1 case of grade 2 dysthyroidism; and there were no grade 4 or higher events. The rate of successful hCG normalization was 96.2% (90% CI, 85.9%-97.9%). After a median (IQR) follow-up of 41 (37-45) months, no relapses were observed. Among patients with childbearing potential and pregnancy intention, 13 of 14 achieved pregnancy (93%).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this nonrandomized clinical trial, avelumab combined with methotrexate demonstrated a manageable safety profile and high efficacy in low-risk GTT in more than 95% of patients, with durable responses and preserved fertility. This combination may represent a promising first-line strategy warranting evaluation in comparative studies, particularly for patients at higher risk of chemoresistance.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04396223<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2026.1697","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:00:20Z","timestamp":1781190020000},"page":"820","source":"Crossref","is-referenced-by-count":2,"title":["Avelumab Plus Methotrexate for Gestational Trophoblastic Tumors"],"prefix":"10.1001","volume":"12","author":[{"given":"Benoit","family":"You","sequence":"first","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"Univ Lyon, Universit\u00e9 Claude Bernard Lyon 1, Facult\u00e9 de M\u00e9decine Lyon-Sud, \u00c9quipe d\u2019Accueil 3738, Centre pour l\u2019Innovation en Canc\u00e9rologie de Lyon, Lyon, France"},{"name":"Medical Oncology, Institut de Canc\u00e9rologie des Hospices Civils de Lyon, Centre d\u2019Investigation et de Traitement des Oncologies H\u00e9matologiques de Lyon, EPSILYON (Early Phase Studies in Lyon), Hospices Civils de Lyon, Lyon, France"},{"name":"GINECO (Groupe d\u2019Investigateurs Nationaux pour l\u2019\u00c9tude des Cancers Ovariens et du sein), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Lotz","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"H\u00f4pital Tenon, Facult\u00e9 de Sant\u00e9, University Hospital Group Sorbonne University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Descargues","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"Department of Gynecological and Oncological Surgery, Obstetrics, Tenon Hospital, South Lyon Hospital Center, Hospices Civils de Lyon, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Joly","sequence":"additional","affiliation":[{"name":"GINECO (Groupe d\u2019Investigateurs Nationaux pour l\u2019\u00c9tude des Cancers Ovariens et du sein), Paris, France"},{"name":"Fran\u00e7ois Baclesse Center, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"De La Motte Rouge","sequence":"additional","affiliation":[{"name":"GINECO (Groupe d\u2019Investigateurs Nationaux pour l\u2019\u00c9tude des Cancers Ovariens et du sein), Paris, France"},{"name":"Eugene Marquis Center, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coriolan","family":"Lebreton","sequence":"additional","affiliation":[{"name":"GINECO (Groupe d\u2019Investigateurs Nationaux pour l\u2019\u00c9tude des Cancers Ovariens et du sein), Paris, France"},{"name":"Bergoni\u00e9 Institute, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Gladieff","sequence":"additional","affiliation":[{"name":"GINECO (Groupe d\u2019Investigateurs Nationaux pour l\u2019\u00c9tude des Cancers Ovariens et du sein), Paris, France"},{"name":"Department of Medical Oncology, Oncopole Claudius Regaud, University Cancer Institute of Toulouse-Oncopole, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Follana","sequence":"additional","affiliation":[{"name":"GINECO (Groupe d\u2019Investigateurs Nationaux pour l\u2019\u00c9tude des Cancers Ovariens et du sein), Paris, France"},{"name":"Antoine Lacassagne Center, Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Jamelot","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"H\u00f4pital Tenon, Facult\u00e9 de Sant\u00e9, University Hospital Group Sorbonne University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Massardier","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"Department of Gynecology and Obstetrics, Antenatal Diagnosis Unit, H\u00f4pital Femme M\u00e8re Enfant, Hospices Civils de Lyon, Bron, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Touria","family":"Hajri","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Msika","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"Univ Lyon, Universit\u00e9 Claude Bernard Lyon 1, Facult\u00e9 de M\u00e9decine Lyon-Sud, \u00c9quipe d\u2019Accueil 3738, Centre pour l\u2019Innovation en Canc\u00e9rologie de Lyon, Lyon, France"},{"name":"Department of Gynecological and Oncological Surgery, Obstetrics, Tenon Hospital, South Lyon Hospital Center, Hospices Civils de Lyon, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marine","family":"Alves-Ferreira","sequence":"additional","affiliation":[{"name":"Clinical Research and Epidemiology Services\u2212Public Health Department, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Bin","sequence":"additional","affiliation":[{"name":"Clinical Research and Epidemiology Services\u2212Public Health Department, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Langlois-Jacques","sequence":"additional","affiliation":[{"name":"Public Health Department, Biostatistics and Bioinformatics Service, Hospices Civils de Lyon, Lyon, France"},{"name":"National Center for Scientific Research, Mixed Research Unit 5558, Laboratory of Biometry and Evolutionary Biology, Biostatistics\u2212Health Team, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Subtil","sequence":"additional","affiliation":[{"name":"Public Health Department, Biostatistics and Bioinformatics Service, Hospices Civils de Lyon, Lyon, France"},{"name":"National Center for Scientific Research, Mixed Research Unit 5558, Laboratory of Biometry and Evolutionary Biology, Biostatistics\u2212Health Team, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeline","family":"Roux","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Databases\u2212Public Health Department, Hospices Civils de Lyon, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Desauw","sequence":"additional","affiliation":[{"name":"Lille University Hospital\u2013Huriez Hospital, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magali","family":"Provansal","sequence":"additional","affiliation":[{"name":"Paoli-Calmettes Institute, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verane","family":"Schwiertz","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, University of Claude Bernard Lyon 1, South Lyon Hospital Center, Hospices Civils de Lyon, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Golfier","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"Univ Lyon, Universit\u00e9 Claude Bernard Lyon 1, Facult\u00e9 de M\u00e9decine Lyon-Sud, \u00c9quipe d\u2019Accueil 3738, Centre pour l\u2019Innovation en Canc\u00e9rologie de Lyon, Lyon, France"},{"name":"Department of Gynecological and Oncological Surgery, Obstetrics, Tenon Hospital, South Lyon Hospital Center, Hospices Civils de Lyon, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Adrien","family":"Bolze","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Trophoblastiques (French Trophoblastic Diseases Reference Center), Lyon, France"},{"name":"Univ Lyon, Universit\u00e9 Claude Bernard Lyon 1, Facult\u00e9 de M\u00e9decine Lyon-Sud, \u00c9quipe d\u2019Accueil 3738, Centre pour l\u2019Innovation en Canc\u00e9rologie de Lyon, Lyon, France"},{"name":"Department of Gynecological and Oncological Surgery, Obstetrics, Tenon Hospital, South Lyon Hospital Center, Hospices Civils de Lyon, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"9742","key":"coi260024r1","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/S0140-6736(10)60280-2","article-title":"Gestational trophoblastic disease.","volume":"376","author":"Seckl","year":"2010","journal-title":"Lancet"},{"issue":"13","key":"coi260024r2","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1016\/j.ejca.2015.05.026","article-title":"Formalised consensus of the European Organisation for Treatment of Trophoblastic Diseases on management of gestational trophoblastic diseases.","volume":"51","author":"Bolze","year":"2015","journal-title":"Eur J Cancer"},{"issue":"7","key":"coi260024r3","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1111\/j.1471-0528.1989.tb03318.x","article-title":"The role of low-dose methotrexate and folinic acid in gestational trophoblastic tumours (GTT).","volume":"96","author":"Bagshawe","year":"1989","journal-title":"Br J Obstet Gynaecol"},{"issue":"18","key":"coi260024r4","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.1200\/JCO-24-02326","article-title":"Practical Guidelines for the Treatment of Gestational Trophoblastic Disease: collaboration of the European Organisation for the Treatment of Trophoblastic Disease (EOTTD)-European Society of Gynaecologic Oncology (ESGO)-Gynecologic Cancer InterGroup (GCIG)-International Society for the Study of Trophoblastic Diseases (ISSTD).","volume":"43","author":"Lok","year":"2025","journal-title":"J Clin Oncol"},{"issue":"1","key":"coi260024r5","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s00280-020-04086-0","article-title":"Validation of an online tool for early prediction of the failure-risk in gestational trophoblastic neoplasia patients treated with methotrexate.","volume":"86","author":"Dekeister","year":"2020","journal-title":"Cancer Chemother Pharmacol"},{"issue":"2","key":"coi260024r6","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.ygyno.2020.05.013","article-title":"An international randomized phase III trial of pulse actinomycin-D versus multi-day methotrexate for the treatment of low risk gestational trophoblastic neoplasia; NRG\/GOG 275.","volume":"158","author":"Schink","year":"2020","journal-title":"Gynecol Oncol"},{"issue":"15","key":"coi260024r7","doi-asserted-by":"publisher","first-page":"3184","DOI":"10.1016\/j.ejca.2013.06.004","article-title":"The outcome of patients with low risk gestational trophoblastic neoplasia treated with single agent intramuscular methotrexate and oral folinic acid.","volume":"49","author":"Taylor","year":"2013","journal-title":"Eur J Cancer"},{"issue":"10","key":"coi260024r8","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/j.annonc.2025.06.006","article-title":"Efficacy and safety of biweekly single-dose actinomycin D versus multiday methotrexate in low-risk gestational trophoblastic neoplasia: a prospective multicenter randomized trial.","volume":"36","author":"Jiang","year":"2025","journal-title":"Ann Oncol"},{"issue":"3","key":"coi260024r9","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.ygyno.2012.03.039","article-title":"Treatment of nonmetastatic and metastatic low-risk gestational trophoblastic neoplasia: factors associated with resistance to single-agent methotrexate chemotherapy.","volume":"125","author":"Chapman-Davis","year":"2012","journal-title":"Gynecol Oncol"},{"issue":"8","key":"coi260024r10","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1016\/S1470-2045(21)00262-X","article-title":"Predictors for single-agent resistance in FIGO score 5 or 6 gestational trophoblastic neoplasia: a multicentre, retrospective, cohort study.","volume":"22","author":"Braga","year":"2021","journal-title":"Lancet Oncol"},{"issue":"11","key":"coi260024r11","doi-asserted-by":"publisher","first-page":"1810","DOI":"10.1038\/bjc.2012.462","article-title":"Treatment outcomes for 618 women with gestational trophoblastic tumours following a molar pregnancy at the Charing Cross Hospital, 2000-2009.","volume":"107","author":"Sita-Lumsden","year":"2012","journal-title":"Br J Cancer"},{"issue":"6","key":"coi260024r12","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007102.pub4","article-title":"First-line chemotherapy in low-risk gestational trophoblastic neoplasia.","volume":"2016","author":"Lawrie","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"coi260024r13","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1200\/JCO.2014.57.5332","article-title":"Effects of single-agent and combination chemotherapy for gestational trophoblastic tumors on risks of second malignancy and early menopause.","volume":"33","author":"Savage","year":"2015","journal-title":"J Clin Oncol"},{"issue":"9","key":"coi260024r14","doi-asserted-by":"publisher","first-page":"673","DOI":"10.3109\/09513590.2015.1054803","article-title":"Reproductive outcomes after hydatiform mole and gestational trophoblastic neoplasia.","volume":"31","author":"Gadducci","year":"2015","journal-title":"Gynecol Endocrinol"},{"issue":"5","key":"coi260024r15","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1097\/IGC.0000000000001248","article-title":"Efficacy and safety of second-line 5-day dactinomycin in case of methotrexate failure for gestational trophoblastic neoplasia.","volume":"28","author":"Prouvot","year":"2018","journal-title":"Int J Gynecol Cancer"},{"key":"coi260024r16","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.gore.2017.07.011","article-title":"Spontaneous regression of gestational trophoblastic neoplasia.","volume":"21","author":"Niimi","year":"2017","journal-title":"Gynecol Oncol Rep"},{"issue":"2","key":"coi260024r17","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1097\/PGP.0000000000000305","article-title":"PD-L1 expression in human placentas and gestational trophoblastic diseases.","volume":"36","author":"Veras","year":"2017","journal-title":"Int J Gynecol Pathol"},{"issue":"3","key":"coi260024r18","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1097\/IGC.0000000000000892","article-title":"PD-L1 expression in premalignant and malignant trophoblasts from gestational trophoblastic diseases is ubiquitous and independent of clinical outcomes.","volume":"27","author":"Bolze","year":"2017","journal-title":"Int J Gynecol Cancer"},{"issue":"11","key":"coi260024r19","doi-asserted-by":"publisher","first-page":"2782","DOI":"10.3390\/cancers14112782","article-title":"Current evidence on immunotherapy for gestational trophoblastic neoplasia (GTN).","volume":"14","author":"Mangili","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"10110","key":"coi260024r20","doi-asserted-by":"publisher","first-page":"2343","DOI":"10.1016\/S0140-6736(17)32894-5","article-title":"Pembrolizumab is effective for drug-resistant gestational trophoblastic neoplasia.","volume":"390","author":"Ghorani","year":"2017","journal-title":"Lancet"},{"issue":"3","key":"coi260024r21","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1159\/000533972","article-title":"Immunotherapy for gestational trophoblastic neoplasia: a new paradigm.","volume":"89","author":"Baas","year":"2024","journal-title":"Gynecol Obstet Invest"},{"issue":"11","key":"coi260024r22","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1016\/S1470-2045(21)00460-5","article-title":"Camrelizumab plus apatinib in patients with high-risk chemorefractory or relapsed gestational trophoblastic neoplasia (CAP 01): a single-arm, open-label, phase 2 trial.","volume":"22","author":"Cheng","year":"2021","journal-title":"Lancet Oncol"},{"issue":"27","key":"coi260024r23","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1200\/JCO.20.00803","article-title":"Avelumab in patients with gestational trophoblastic tumors with resistance to single-agent chemotherapy: cohort A of the TROPHIMMUN phase II trial.","volume":"38","author":"You","year":"2020","journal-title":"J Clin Oncol"},{"key":"coi260024r24","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.ygyno.2022.11.005","article-title":"Avelumab in patients with gestational trophoblastic tumors with resistance to polychemotherapy: cohort B of the TROPHIMMUN phase 2 trial.","volume":"168","author":"You","year":"2023","journal-title":"Gynecol Oncol"},{"issue":"34","key":"coi260024r25","doi-asserted-by":"publisher","first-page":"A45","DOI":"10.1136\/ijgc-2024-ESGO.57","article-title":"TROPHIMMUN, cohort A: maintained benefit from second-line avelumab after failure to monochemotherapy in low-risk gestational trophoblastic tumor, with a 4 year-follow-up.","volume":"2024","author":"You","year":"2024","journal-title":"Int J Gynecol Cancer"},{"issue":"1","key":"coi260024r26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0197-2456(89)90015-9","article-title":"Optimal two-stage designs for phase II clinical trials.","volume":"10","author":"Simon","year":"1989","journal-title":"Control Clin Trials"},{"issue":"1","key":"coi260024r27","doi-asserted-by":"publisher","first-page":"80.e1","DOI":"10.1016\/j.ajog.2016.01.183","article-title":"Predictive factors of relapse in low-risk gestational trophoblastic neoplasia patients successfully treated with methotrexate alone.","volume":"215","author":"Couder","year":"2016","journal-title":"Am J Obstet Gynecol"},{"issue":"2","key":"coi260024r28","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1097\/IGC.0000000000001175","article-title":"Reproductive outcomes after gestational trophoblastic neoplasia. a comparison between single-agent and multiagent chemotherapy: retrospective analysis from the MITO-9 group.","volume":"28","author":"Cioffi","year":"2018","journal-title":"Int J Gynecol Cancer"},{"issue":"4","key":"coi260024r29","doi-asserted-by":"publisher","first-page":"381.e1","DOI":"10.1016\/j.ajog.2024.09.115","article-title":"FcgammaR3A polymorphism influences natural killer cell activation and response to anti-PD-L1 (avelumab) in gestational trophoblastic neoplasia.","volume":"232","author":"Msika","year":"2025","journal-title":"Am J Obstet Gynecol"},{"key":"coi260024r30","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101974","article-title":"Anti-PD-1 therapy plus chemotherapy versus anti-PD-1 therapy alone in patients with high-risk chemorefractory or relapsed gestational trophoblastic neoplasia: a multicenter, retrospective study.","volume":"59","author":"Wang","year":"2023","journal-title":"EClinicalMedicine"},{"key":"coi260024r31","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008891.pub2","article-title":"Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia.","volume":"12","author":"Alazzam","year":"2012","journal-title":"Cochrane Database Syst Rev"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2850488\/jamaoncology_you_2026_oi_260024_1787161692.83313.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:02:38Z","timestamp":1787238158000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2850488"}},"subtitle":["The TROPHAMET Phase 1\/2 Nonrandomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":31,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2026.1697","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,1]]}}}