[Current advances and challenges of immunotherapy in gestational trophoblastic neoplasia].

Gestational trophoblastic neoplasia (GTN) represents a rare group of malignant tumors arising from trophoblastic tissue. These tumors are highly curable owing to their remarkable sensitivity to chemotherapy, yet treatment remains challenging in patients with high-risk disease, multi-drug resistance, or rare subtypes. Recent advances in immune checkpoint inhibitor (ICI) have expanded therapeutic possibilities for GTN. Some patients with recurrence or drug resistance have achieved long-term remission after treatment with programmed death receptor 1 (PD-1) and its programmed cell death ligand-1 (PD-L1) inhibitors.. Basic studies have revealed unique immunological features of GTN--including strong antigenicity, abundant immune cell infiltration, and high checkpoint expression--providing a biological rationale for immunotherapy. However, several key questions remain, including optimal treatment timing, long-term safety, fertility outcomes, and predictive biomarkers. Based on existing research findings, this review article discusses the current application status and controversies of GTN, proposes key directions for future development, and aims to provide references for clinical practice and follow-up research.