GYNECOLOGIC CANCER: Edited by Gottfried E. KonecnyTreatment of gestational trophoblastic disease in the 2020sClark, James J.; Slater, Susanna; Seckl, Michael J.Author Information Gestational Trophoblastic Disease Centre, Charing Cross Hospital Campus of Imperial College London, London, UK Correspondence to Michael J. Seckl, PhD, FRCP, FMedSci, Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College London, Fulham Palace Road, London W6 8RF, UK. Tel: +44 20 33111421; e-mail: [email protected] Current Opinion in Obstetrics and Gynecology: February 2021 - Volume 33 - Issue 1 - p 7-12 doi: 10.1097/GCO.0000000000000674 Buy Metrics Abstract Purpose of review This review demonstrates the evidence for new systemic anticancer treatments and how they integrate within conventional management for gestational trophoblastic neoplasia (GTN). We present the evidence on atypical placental site nodules, and how they incorporate within the GTN spectrum, as well as updates regarding GTN staging and follow-up. Recent findings First-line treatment for GTN still lies in conventional chemotherapy, although the introduction of anti-PD1/PD-L1 immune checkpoint inhibitors has shown significant promise in management of relapsed disease, with responses reported in multiple relapsed choriocarcinomas as well as epithelioid trophoblastic tumours and placental site trophoblastic tumours (ETT/PSTT). Following completion of treatment, ETT/PSTT still require life-long surveillance but for other GTN, no recurrences have been detected after 7 years. Summary Checkpoint inhibitors are likely to play an increasing role in the future management of GTN management. Further refinement of prognostic factors to identify those most at risk of GTN recurrence is warranted so that surveillance can be focussed on those most at risk, whilst minimizing unnecessary intervention for those at lower risk. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.