Gestational trophoblastic diseases
Gestational trophoblastic diseases are a group of diseases affecting the development of the placenta. This transitory organ which develops with the fetus, allows the growth of the fetus during its life in utero and is normally evacuated during delivery.
In some cases (1 pregnancy in 1000), it develops abnormally, in the form of a very large placenta, usually without development of the fetus. This anomaly is called hydatidiform mole and must be treated by evacuation (suction curettage).
In approximately 15% of cases after hydatidiform mole, the disease transforms into a trophoblastic tumor, sometimes associated with metastases. The treatment is based on chemotherapy, and thanks to this treatment, the cure rate is about 100%. |
In other, much rarer cases (1 pregnancy in 10,000), when the pregnancy and childbirth have taken place normally, certain cells from the placenta persist in the uterus and transform into an aggressive trophoblastic tumor called choriocarcinoma.
In the same way, the disease progresses to metastases affecting several organs, and the treatment is based on chemotherapy. |
There is an exceptionally rare (1 in 100,000 pregnancies) form of trophoblastic tumor developing after childbirth called placental site trophoblastic tumor (PSTT).
This disease very rarely progresses to metastases and generally remains localized in the uterus. However, chemotherapy is generally not effective on PSTT and to date, surgery has been used to treat this disease. When a PSTT only affects the uterus, without metastasis, the prognosis is very good with more than 92% survival. Unfortunately, to surgically treat a PSTT located in the uterus, it is necessary to remove the uterus, which prevents carrying a new pregnancy. |
Scientific and medical research
The work carried out by the teams involved in the management of trophoblastic diseases shows that beyond traditional treatments (chemotherapy and surgery), new treatments called immunotherapies could cure patients suffering from trophoblastic tumors in whom chemotherapy or surgery are ineffective. Immunotherapies could even replace chemotherapy and surgery, in certain specific situations, and thus maintain fertility.
The research carried out by the French Reference Center for Trophoblastic Diseases (Lyon) seeks to understand the mechanisms of tolerance of trophoblastic tumors by the immune system.
A major research project, supported by the ZZ Association for Research and treatment of rare diseases and cancer, launched in 2023 and during the next 5 years within the University Lyon 1 and the Hospices Civils de Lyon, will make it possible to advance the biomedical science and the diagnostic and therapeutic management of patients with trophoblastic tumors, in particular PSTT, through 4 main areas of research:
The research carried out by the French Reference Center for Trophoblastic Diseases (Lyon) seeks to understand the mechanisms of tolerance of trophoblastic tumors by the immune system.
A major research project, supported by the ZZ Association for Research and treatment of rare diseases and cancer, launched in 2023 and during the next 5 years within the University Lyon 1 and the Hospices Civils de Lyon, will make it possible to advance the biomedical science and the diagnostic and therapeutic management of patients with trophoblastic tumors, in particular PSTT, through 4 main areas of research:
Axe 1Understanding the immune interaction between tumor and patient |
Axe 2Early detection of tumor transformation |
Axe 3Identify new therapeutic targets/vectors |
Axe 4Test in vitro the sensitivity of PSTT tumor cells |