Study of PD-1 Antibody and Bevacizumab in the Treatment of High-risk GTN After Combined Chemotherapy

Gestational trophoblastic Neoplasia（GTN） is a kind of malignant tumor in women of childbearing age. It is easy to metastasized through the blood system in the early stage, so it is a relatively malignant tumor. The tumor is highly sensitive to chemotherapy, and low-risk patients have good prognosis, with survival rate and cure rate approaching 100%, but high-risk patients are prone to drug resistance, or relapse after remission. For relapsed, refractory, high-risk GTN, multiple remedies have been reported in the literature, but the remission rate is only 75-80%. For relapsed or refractory high-risk GTN, multiple remedies have been reported in the literature, but the remission rate is only 75-80%. Currently, targeted therapy and immunotherapy are widely used in various refractory solid tumors. For GTN, there are also a number of related studies. In this study, PD-1 inhibitors combined with bevacizumab were used to treat refractory high-risk GTN with relapse or drug resistance after receiving previous second-line or above multidrug combination therapy, to study the efficacy and safety of the treatment regimen.

Sex

Female

Minimum age

18 Years

Maximum age

75 Years

Inclusion Criteria:

1. Signed Informed Consent
2. Clinically diagnosed as recurrent or drug-resistant trophoblastic tumor
3. After treatment with at least two or more multidrug chemotherapy regimens
4. Survival is expected to exceed 3 months
5. Age ≥18 years, age ≤75 years
6. Karnofsky score ≥60分，ECOG score ≤2分
7. No serious complications
8. Take effective contraceptives during treatment
9. Patients can be followed up as required
10. Blood test within 3 days: ANC≥1.5×109/L, PT ≥100×109/L, Hb≥90g/L, BIL ≤ 1.5 times of the high limit of normal value, ALT/ALST ≤ 1.5 times of the high limit of normal value, BUN and Cr≤ normal value
11. Coagulation function, thyroid function and myocardial enzyme in the normal range

Exclusion Criteria:

1. Previously, he had received anti-PD-1, anti-PD-L1, bevacizumab and other drugs;
2. Within 2 weeks before the first administration, he had received anticancer Chinese patent medicine or immunomodulatory drugs;
3. Within 2 years before the first administration, he had received active autoimmune disease requiring systemic treatment;
4. Were receiving systemic glucocorticoid therapy or any other form of immunosuppressive therapy within 7 days prior to first administration;
5. Clinically uncontrollable pleural effusion/peritoneal effusion is present;
6. Allergic to PD-1 monoantibody, bevacizumab and other active ingredients or excipients；
7. Failure to fully recover from toxicity and/or complications；
8. History of HIV infection, untreated active hepatitis B, and active HCV infection subjects；
9. Live vaccine was administered within 30 days prior to the first dose；
10. Patients with serious or uncontrollable medical conditions who are not suitable for chemotherapy；
11. Participating in clinical trials of other drugs at the same time or 4 weeks before the first administration。

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