Immune checkpoint inhibitor using in cases with gestational trophoblastic diseases.

Female Pregnancy Humans Immune Checkpoint Inhibitors / therapeutic use Gestational Trophoblastic Disease / drug therapy Immunotherapy Multicenter Studies as Topic
Gestational trophoblastic neoplasia Immune checkpoint inhibitors Immune microenvironment

Journal

Medical oncology (Northwood, London, England)
ISSN: 1559-131X
Titre abrégé: Med Oncol
Pays: United States
ID NLM: 9435512

Informations de publication

Date de publication:
23 Feb 2023
Historique:
received: 11 11 2022
accepted: 24 12 2022
entrez: 24 2 2023
pubmed: 25 2 2023
medline: 3 3 2023
Statut: epublish

Résumé

Gestational trophoblastic neoplasias (GTNs) are chemosensitive disorders with very high cure rates. However, individuals with chemoresistant diseases pass away as a result of their illness, necessitating the use of innovative medications. Immune checkpoint inhibitors (ICIs) are a critical component of the strategy for the management of drug-resistant GTD due to the high rate of PD-1 expression and the paternal genetic inheritance in GTNs. Immunotherapy is mentioned as a potential therapeutic approach for chemotherapy-resistant GTD in the most recent worldwide recommendations. However, multicenter worldwide collaborative studies are required to give additional evidence to detect and identify prognostic markers due to the rarity of GTDs and the dearth of data in the literature.

Identifiants

DOI: 10.1007/s12032-022-01941-3 PMID: 36823367
pubmed: 36823367
doi: 10.1007/s12032-022-01941-3
pii: 10.1007/s12032-022-01941-3
doi:

Substances chimiques

Immune Checkpoint Inhibitors 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

106

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Angiolo G, Silvestro C, Guerrieri ME, Damiano AG. Placental site trophoblastic tumor and epithelioid trophoblastic tumor: clinical and pathological features, prognostic variables and treatment strategy. Gynecol Oncol. 2019;153:684–93.
doi: 10.1016/j.ygyno.2019.03.011
Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376:717–29.
pubmed: 20673583 doi: 10.1016/S0140-6736(10)60280-2
Ning F, Hou H, Morse AN, Lash GE. Understanding and management of gestational trophoblastic disease. F1000Research. 2019;8:428.
doi: 10.12688/f1000research.14953.1
Kato M, Tanaka K, Takeuchi S. The nature of trophoblastic disease initiated by transplantation into immunosuppressed animals. Obstetric. 1982;142(5):497–505.
doi: 10.1016/0002-9378(82)90751-7
Smith HO, Qualls CR, Prairie BA, Padilla LA, Rayburn WF, Key CR. Trends in gestational choriocarcinoma: a 27-year perspective. Obstet Gynecol. 2003;102(5):978–87.
pubmed: 14672473
Shanmugaratnam K, Muir CS, Tow SH, Cheng WC, Christine B, Pedersen E. Rates per 100,000 births and incidence of choriocarcinoma and malignant mole in Singapore Chinese and Malays. Comparison with connecticut Norway and Sweden. Int J Cancer. 1971;8:165–75.
pubmed: 5118207 doi: 10.1002/ijc.2910080120
Altieri A, Franceschi S, Ferlay J, Smith J, La Vecchia C. Epidemiology and aetiology of gestational trophoblastic diseases. Lancet Oncol. 2003;4:670–8.
pubmed: 14602247 doi: 10.1016/S1470-2045(03)01245-2
Elias KM, Berkowitz RS, Horowitz NS. State-of-the-art workup and initial management of newly diagnosed molar pregnancy and postmolar gestational trophoblastic neoplasia. J Natl Compr Cancer Netw. 2019;17:1396–401.
doi: 10.6004/jnccn.2019.7364
Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, Lurain JR, Massuger L. Diagnosis and management of gestational trophoblastic disease: 2021 update. Int J Gynaecol Obstet. 2021;155(Suppl 1):86–93.
pubmed: 34669197 pmcid: 9298230 doi: 10.1002/ijgo.13877
-Abu-Rustum NR, Yashar CM, Bradley K et al (2003). Gestational Trophoblastic Neoplasia, Version 1.2022, NCCN Clinical Practice Guidelines in Oncology. Online to NCCN.org.
Mangili G, Lorusso D, Brown J, et al. Trophoblastic disease review for diagnosis and management: a joint report from the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup. Int J Gynecol Cancer. 2014;24(Suppl. S3):S109–16.
pubmed: 25341573 doi: 10.1097/IGC.0000000000000294
Mangili G, Sabetta G, Cioffi R, Rabaiotti E, Candotti G, Pella F, Candiani M, Bergamini A. Current evidence on immunotherapy for gestational trophoblastic neoplasia (GTN). Cancers (Basel). 2022;3(14):2782.
doi: 10.3390/cancers14112782
King JR, Wilson ML, Hetey S, Kiraly P, et al. Dysregulation of placental functions and immune pathways in complete hydatidiform moles. Int J Mol Sci. 2019;20:4999.
pubmed: 31658584 pmcid: 6829352 doi: 10.3390/ijms20204999
Frega G, Kepp O, Turchetti D, Rizzo A, Pantaleo MA, Brandi G. Hypothesis on the possible relevance of the immunogenic cell death in the treatment of gestational trophoblastic neoplasms. Transl Oncol. 2021;12: 101224.
doi: 10.1016/j.tranon.2021.101224
Szabolcsi Z, Demeter A, Kiraly P, et al. Epigenetic dysregulation of trophoblastic gene expression in gestational trophoblastic disease. Biomedicines. 2021;9:1935.
pubmed: 34944751 pmcid: 8698431 doi: 10.3390/biomedicines9121935
Gomez S, Tabernacki T, Kobyra J, Roberts P, Chiappinelli KB. Combining epigenetic and immune therapy to overcome cancer resistance. Semin Cancer Biol. 2020;65:99–113.
pubmed: 31877341 doi: 10.1016/j.semcancer.2019.12.019
Guleria I, Khosroshahi A, Ansari MJ, et al. A critical role for the programmed death ligand 1 in fetomaternal tolerance. J Exp Med. 2005;202:231–7.
pubmed: 16027236 pmcid: 2213002 doi: 10.1084/jem.20050019
Ghorani E, Kaur B, Fisher RA, et al. Pembrolizumab is effective for drug-resistant gestational trophoblastic neoplasia. The Lancet. 2017;390:2343–5.
doi: 10.1016/S0140-6736(17)32894-5
Fülöp V, Szigetvári I, Szepesi J, et al. 30 years’ experience in the treatment of low- risk gestational trophoblastic neoplasia in Hungary. J Reprod Med. 2010;55:253–7.
pubmed: 20626182
Liu TL, Deppe G, Chang QT, Tan TT. Cerebral metastatic choriocarcinoma in the People’s Republic of China. Gynecol Oncol. 1983;15:166–70.
pubmed: 6682069 doi: 10.1016/0090-8258(83)90071-9
Lorch A, Neubauer A, Hackenthal M, et al. High-dose chemotherapy (HDCT) as second salvage treatment in patients with multiple relapsed or refractory germ-cell tumors. Ann Oncol. 2010;21:820e5.
doi: 10.1093/annonc/mdp366
Salman L, Bouchard-Fortier G, Covens A. Immune checkpoint inhibitors for the treatment of gestational trophoblastic neoplasia: rationale, effectiveness, and future fertility. Curr Treat Options in Oncol. 2022;23:1035–43.
doi: 10.1007/s11864-022-00988-8
Nakazaki H, Tokuyasu H, Takemoto Y, et al. Pulmonary metastatic choriocarcinoma from a burned-out testicular tumor. Intern Med. 2016;55:1481–5.
pubmed: 27250057 doi: 10.2169/internalmedicine.55.5679
Ngan HY, Bende H, Benedet JL, Jones H, Montruccoli GC, Pecorelli S. FIGO Committee on gynecologic oncology. Gestational trophoblastic neoplasia FIGO 2000 staging and classification. Int J Gynaecol Obstet. 2003;83(Suppl S1):175–7.
pubmed: 14763174 doi: 10.1016/S0020-7292(03)90120-2
Park HJ, Cho HY, Cha DH. The amniotic fluid cell-free transcriptome provides novel information about fetal development and placental cellular dynamics. Int J Mol Sci. 2021;22(5):2612.
pubmed: 33807645 pmcid: 7961801 doi: 10.3390/ijms22052612
Polterauer PVS, Poetsch N, Reinthaller A, Grimm C, Bartl T. Long-term survival in multiresistant metastatic choriocarcinoma after pembrolizumab treatment: a case report. Gynecol Oncol Rep. 2021;37: 100817.
pubmed: 34258357 pmcid: 8253948 doi: 10.1016/j.gore.2021.100817
Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, Lurain JR, Massuger L. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet. 2018;143(Suppl 2):79–85.
pubmed: 30306586 doi: 10.1002/ijgo.12615
Tryakin A, Fedyanin M, Bulanov A, et al. Dose-reduced first cycle of chemotherapy for prevention of lifethreatening acute complications in nonseminomatous germ cell tumor patients with ultra high tumor markers and/or poor performance status. J Cancer Res Clin Oncol. 2018;144:1817–23.
pubmed: 29974210 doi: 10.1007/s00432-018-2695-4
Powles T, Savage PM, Stebbing J, et al. A comparison of patients with relapsed and chemo-refractory gestational trophoblastic neoplasia. Br J Cancer. 2007;12(96):732–7.
doi: 10.1038/sj.bjc.6603608
Oechsle K, Honecker F, Cheng T, et al. Preclinical and clinical activity of sunitinib in patients with cisplatin-refractory or multiply relapsed germ cell tumors: a Canadian Urologic Oncology Group/German Testicular Cancer Study Group cooperative study. Ann Oncol. 2011;22:2654e60.
doi: 10.1093/annonc/mdr026
Mego M, Svetlovska D, Miskovska V, et al. Phase II study of everolimus in refractory testicular germ cell tumors. Urol Oncol. 2016;34(3):122-e17.
doi: 10.1016/j.urolonc.2015.10.010
Herbst RS, Baas P, Kim DW, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet. 387(10027), 1540–1550.52-Huang M, Pinto A, Castillo RP, Slomovitz BM (2017). Complete serologic response to Pembrolizumab in a woman with chemoresistant metastatic choriocarcinoma. J Clin Oncol. 2016;35:3172–4.
Abi Nahed R, Elkhoury Mikhael M, Reynaud D, et al. Role of NLRP7 in normal and malignant trophoblast cells. Biomedicines. 2022;10(2):252. https://doi.org/10.3390/biomedicines10020252 .
doi: 10.3390/biomedicines10020252 pubmed: 35203462 pmcid: 8868573
Reynaud D, Abi Nahed R, Lemaitre N, et al. NLRP7 promotes choriocarcinoma growth and progression through the establishment of an immunosuppressive microenvironment. Cancers. 2021;13:2999.
pubmed: 34203890 pmcid: 8232770 doi: 10.3390/cancers13122999
Rustin GJ, Newlands ES, Begent RH, Dent J, Bagshawe KD. Weekly alternating etoposide, methotrexate, and actinomycin/vincristine and cyclophosphamide chemotherapy for the treatment of CNS metastases of choriocarcinoma. J Clin Oncol Off J Am Soc Clin Oncol. 1989;7:900–3.
doi: 10.1200/JCO.1989.7.7.900
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. Gynecol Oncol Rep ep. 2020;1(34): 100625.
doi: 10.1016/j.gore.2020.100625
Athanassiou A, Begent RH, Newlands ES, Parker D, Rustin GJ, Bagshawe KD. Central nervous system metastases of choriocarcinoma. 23 years’ experience at charing cross hospital. Cancer. 1983;52:1728–35.
pubmed: 6684500 doi: 10.1002/1097-0142(19831101)52:9<1728::AID-CNCR2820520929>3.0.CO;2-U
Buchbinder EI, Desai A. CTLA-4 and PD-1 pathways: similarities, differences, and implications of their inhibition. Am J Clin Oncol. 2016;39:98–106.
pubmed: 26558876 pmcid: 4892769 doi: 10.1097/COC.0000000000000239
Seidel JA, Otsuka A, Kabashima K. Anti-PD-1 and Anti-CTLA-4 therapies in cancer: mechanisms of action, efficacy, and limitations. Front Oncol. 2018;28(8):86.
doi: 10.3389/fonc.2018.00086
Zong L, Zhang M, WangW Wan X, Yang J, Xiang Y. PD-L1, B7–H3 and VISTA are highly expressed in gestational trophoblastic neoplasia. Histopathology. 2019;75(3):421–30.
pubmed: 31013360 doi: 10.1111/his.13882
Veras E, Kurman RJ, Wang T-L, Shih I-M. PD-L1 Expression in human placentas and gestational trophoblastic diseases. Int J Gynecol Pathol. 2017;36:146–53.
pubmed: 27362903 pmcid: 5518625 doi: 10.1097/PGP.0000000000000305
Bolze PA, Patrier S, Massardier J, et al. PD-L1 Expression in premalignant and malignant trophoblasts from gestational trophoblastic diseases is ubiquitous and independent of clinical outcomes. Int J Gynecol Cancer. 2017;27:554–61.
pubmed: 28060141 doi: 10.1097/IGC.0000000000000892
Inaguma S, Wang Z, Lasota J, et al. Comprehensive immunohistochemical study of programmed cell death ligand 1 (PD-L1): analysis in 5536 cases revealed consistent expression in trophoblastic tumors. Am J Surg Pathol. 2016;40:1133–42.
pubmed: 27158757 pmcid: 4942373 doi: 10.1097/PAS.0000000000000653
Seymour L, Bogaerts J, Perrone A, et al. iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics. Lancet Oncol. 2017;18:e143–52.
pubmed: 28271869 pmcid: 5648544 doi: 10.1016/S1470-2045(17)30074-8
Golfier F, Raudrant D, Frappart L, et al. First epidemiological data from the French Trophoblastic Disease Reference Center. Am J Obstet Gynecol. 2007;196:172.e1-172.e5.
pubmed: 17306669 doi: 10.1016/j.ajog.2006.10.867
Simon R. Optimal two-stage designs for phase II clinical trials. Control Clin Trials. 1989;10:1–10.
pubmed: 2702835 doi: 10.1016/0197-2456(89)90015-9
Jorgensen JT. Twenty years with personalized medicine: past, present, and future of individualized pharmacotherapy. Oncologist. 2019;2019:432–40.
doi: 10.1634/theoncologist.2019-0054
Chen Y, Haiyan Ye H, Tang J, Weng Y, Zhang J, Liu J. Case report: first-line immune checkpoint inhibitor plus chemotherapy for oral metastasis in a patient with ultra high-risk gestational choriocarcinoma. Cancer Manag Res. 2022;14:1867–75.
pubmed: 35686158 pmcid: 9172735 doi: 10.2147/CMAR.S351165
Huang M, Pinto A, Castillo RP, Slomovitz BM. Complete serologic response to pembrolizumab in a woman with chemoresistant metastatic choriocarcinoma. J Clin Oncol. 2017;35:3172–4.
pubmed: 28742453 doi: 10.1200/JCO.2017.74.4052
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. Gynecol Oncol Rep. 2020;34: 100625.
pubmed: 32964090 pmcid: 7490982 doi: 10.1016/j.gore.2020.100625
Kazemi NY, Langstraat C, Weroha CS. Non-gestational choriocarcinoma with hyperprogression on pembrolizumab: a case report and review of the literature. Gynecol Oncol Rep. 2022;39: 100923.
pubmed: 35111894 pmcid: 8789587 doi: 10.1016/j.gore.2022.100923
Porter A, Barcelon JM, Budker RL, et al. Treatment of metastatic placental site trophoblastic tumor with surgery, chemotherapy, immunotherapy and coil embolization of multiple pulmonary arteriovenous fistulate. Gynecol Oncol Rep. 2021;36: 100782.
pubmed: 34036138 pmcid: 8134973 doi: 10.1016/j.gore.2021.100782
You B, Bolze PA, Jean-Pierre Lotz JP, et al. Avelumab in patients with gestational trophoblastic tumors with resistance to single-agent chemotherapy: cohort A of the TROPHIMMUN phase II trial. J Clin Oncol. 2020;38:3129–37.
pubmed: 32716740 pmcid: 7499607 doi: 10.1200/JCO.20.00803
Cheng H, Zong L, Kong Y, et al. Camrelizumab plus apatinib in patients with high- risk chemorefractory or relapsed gestational trophoblastic neoplasia (CAP-01): a single arm, open-label phase 2 study. Lancet Oncol. 2021;22:1609–17.
pubmed: 34624252 doi: 10.1016/S1470-2045(21)00460-5
Abu-Rustum NR, Yashar CM,Bradley K et al (2022).Gestational Trophoblastic Neoplasia, Version 1. NCCN Clinical Practice Guidelines in Oncology. Online to NCCN.org
Paulino E, de Melo AC. Immunotherapy in gestational trophoblastic neoplasia: great times are coming. Int J Gynecol Cancer. 2020;30:1654–5.
pubmed: 32848022 doi: 10.1136/ijgc-2020-001943
Worley MJ, Elias KM, Horowitz NS, Quade BJ, Berkowitz RS. Durable remission for a woman with refractory choriocarcinoma treated with anti-endoglin monoclonal antibody and bevacizumab: a case from the New England Trophoblastic Disease Center, Brigham and Women’s Hospital and Dana-Farber Cancer Institute. Gynecol Oncol. 2018;148:5–11.
pubmed: 29217138 doi: 10.1016/j.ygyno.2017.11.029
Tumeh PC, Harview CL, Yearley JH, et al. PD-1 blockade induces responses by inhibiting adaptive immune resistance. Nature. 2014;515:568–71.
pubmed: 25428505 pmcid: 4246418 doi: 10.1038/nature13954
Choi MC, Oh J, Lee C. Effective anti-programmed cell death 1 treatment for chemoresistant gestational trophoblastic neoplasia. Eur J Cancer. 2019;121:94–7.
pubmed: 31569067 doi: 10.1016/j.ejca.2019.08.024
Goldfarb JA, Dinoi G, Mariani A, Langstraat CL. A case of multi-agent drug resistant choriocarcinoma treated with Pembrolizumab. Gynecol Oncol Rep. 2020;32: 100574.
pubmed: 32395603 pmcid: 7210394 doi: 10.1016/j.gore.2020.100574
Pisani D, Calleja-Agius J, Di Fiore R, et al. Epithelioid trophoblastic tumour: a case with genetic linkage to a child born over seventeen years prior, successfully treated with surgery and pembrolizumab. Curr Oncol. 2021;28:5346–55.
pubmed: 34940085 pmcid: 8700667 doi: 10.3390/curroncol28060446
Bell SG, Uppal S, Sakala MD, Sciallis AP, Rolston A. An extrauterine extensively metastatic epithelioid trophoblastic tumor responsive to pembrolizumab. Gynecol Oncol Rep. 2021;37: 100819.
pubmed: 34258359 pmcid: 8258853 doi: 10.1016/j.gore.2021.100819
Moffett A, Chazara O, Colucci F. Maternal allo-recognition of the fetus. Fertil Steril. 2017;107:1269–72.
pubmed: 28577615 doi: 10.1016/j.fertnstert.2017.05.001
Waldhauer I, Steinle A. NK cells and cancer immunosurveillance. Oncogene. 2008;27:5932–43.
pubmed: 18836474 doi: 10.1038/onc.2008.267
Wong AJ, Finch L, Pearson JM, Pinto A, Huang M. Retreatment of chemotherapy- resistant metastatic choriocarcinoma with immunotherapy. Gynecologic Oncology Reports. 2022;40: 100955.
pubmed: 35300054 pmcid: 8920859 doi: 10.1016/j.gore.2022.100955
Urosevic M, Dummer R. Human leukocyte antigen-G and cancer immunoediting. Cancer Res. 2008;68:627–30.
pubmed: 18245459 doi: 10.1158/0008-5472.CAN-07-2704
Joneborg U, Coopmans L, van Trommel N, Seckl M, Lok CAR. Fertility and pregnancy outcome in gestational trophoblastic disease. Int J Gynecol Cancer. 2021;31:399–411.
pubmed: 33649007 doi: 10.1136/ijgc-2020-001784
Kato S, Goodman A, Walavalkar V, Barkauskas DA, Sharabi A, Kurzrock R. Hyperprogressors after immunotherapy: analysis of genomic alterations associated with accelerated growth rate. Clin Cancer Res. 2017;23(15):4242–50.
pubmed: 28351930 pmcid: 5647162 doi: 10.1158/1078-0432.CCR-16-3133
ZengW QS, Wang R, et al. PD-L1 blockage increases fetal resorption and Tfr cells but does not affect Tfh/Tfr ratio and B-cell maturation during allogeneic pregnancy. Cell Death Dis. 2020;11:119.
doi: 10.1038/s41419-020-2313-7
Polnaszek B, Mullen M, Bligard K, Raghuraman N, Massad LS. Term pregnancy after complete response of placental site trophoblastic tumor to immunotherapy. Obstet Gynecol. 2021;138:115–8.
pubmed: 34259474 doi: 10.1097/AOG.0000000000004434

Auteurs

Semra Paydas (S)

Dept of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey. sepay@cu.edu.tr.
ORCID: 0000-0003-4642-3693

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Immune checkpoint inhibitor using in cases...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Immune checkpoint inhibitor using in cases...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Antinéoplasiques › Antinéoplasiques immunologiques › Inhibiteurs de points de contrôle immunitaires › Immune checkpoint inhibitor using in cases...
questionsmedicales.fr › Maladies urogénitales › Maladies de l'appareil urogénital féminin et complications de la grossesse › Complications de la grossesse › Complications tumorales de la grossesse › Tumeurs trophoblastiques › Maladie trophoblastique gestationnelle › Immune checkpoint inhibitor using in cases...
questionsmedicales.fr › Thérapeutique › Biothérapie › Immunothérapie › Immune checkpoint inhibitor using in cases...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études multicentriques comme sujet › Immune checkpoint inhibitor using in cases...