EOTTD newsletter January 2023

As an attempt to reach the members of EOTTD and others interested in the field of GTD, the EOTTD board will publish regular updates on upcoming meetings, updates from the working parties and other current events or news, in regular newsletters. If you are interested in a special topic or want to add something in the newsletter, please contact the EOTTD board.

History of EOTTD
EOTTD is an academic organization which was founded in 2010 by professors Michael Seckl, Imperial College, London, U.K, Francois Golfier, Hospices Civils de Lyon, Lyon, France and Leon Massuger, Radboud University Medical Centre, Nijmegen, the Netherlands. The mission with EOTTD was to improve management of women in Europe affected by GTD by disseminating best practice but also to facilitate learning and research. The first EOTTD meeting was held in 2010 in Lyon France and thereafter there were biannual meetings at different European centres until 2016. Since 2017 the EOTTD meetings have been held yearly except for during the pandemic in 2020. The meetings are divided into a day of teaching about GTD and a day for the different working parties to assemble and continue their work. As a part of the mission of learning, the EOTTD also give teaching sessions at newly formed centres. So far teaching sessions have been held in five countries and more are planned. For more information, please see the EOTTD website eottd.org.

Updates from the working parties

1. Clinical working party
   At their last meeting, the clinical working party of EOTTD met with representatives of ESGO (European Society of Gynecological Oncology), ISSTD (International Society for the Study of Trophoblastic Diseases) and GCIG (Gynecological Cancer InterGroup) in an attempt to develop joint international clinical guidelines for GTD. The already published EOTTD clinical guidelines were discussed and modified according to the discussions in the international group. There is still further work to be done and regular meetings are planned.
   
   
2. Pathology and genetics working party
   No update yet.
   
   
3. Biochemistry working party
   For the past months the hCG working group has enthusiastically devoted its time to writing the manuscript “Measurement of hCG in women with Gestational Trophoblastic Disease: why we need harmonization and reference laboratories. Lesley M. McMahon1*, Caroline M. Joyce2*, Lyndsey Cuthill1, Hugh Mitchell3, Imran Jabbar4, Fred C.G.J. Sweep5 on behalf of the hCG working party of the EOTTD”, which will be published as a chapter in the special EOTTD issue of Gynecologic and Obstetric Investigation.
   
   
4. Nurses working party
   The nurses working group has submitted their GTD best practice nursing guidelines to Gynecologic and Obstetric Investigation Journal and is pending review. The group continues to support each centre and engage in 3-monthly online teachings. The Scottish nursing team has now also joined the working party and there is a continuous effort to get other European teams to join.
   Reporting from the ISSTD conference, Sheffield is developing a menopause booklet for ladies who receive combination chemotherapy and their treatment online support groups continue to be a success. They have also introduced online support groups for women on monitoring for GTD.  

Meetings
The International Society for the Study of Trophoblastic Disease (ISSTD) holds biannual meetings with circulating venues around the globe. Due to the pandemic, last year´s planned meeting was postponed, but the much awaited XXI World Congress on Gestational Trophoblastic Diseases was finally held in Sydney, Australia on October 19-22 2022. The hybrid meeting was a success and attracted participants from around the world, and except for scientific presentations also included a ghost tour and dinner. The next ISSTD meeting is planned to take place in Lyon, France in 2024.

        The president of EOTTD at the ISSTD meeting 2022.

Upcoming meetings:

Teaching sessions
As a part of an outreach program to facilitate the establishment of new GTD centres, the board members of the EOTTD hold teaching sessions in hospitals which have expressed an interest in improving care of GTD patients. In September 2022, four members of the EOTTD board came to the new national GTD centre at Karolinska University Hospital in Stockholm, Sweden for a whole day of lectures and case discussions. The session was much appreciated and attracted participants from different medical fields both on-site and virtually. The day finished with a nice dinner together.

Photo published in the Karolinska newsletter with local and European participants in the GTD teaching session.

Dinner company in Stockholm

Upcoming teaching sessions

o    Belgrade, Serbia – 2023

o    Reykjavik, Iceland – 2023

EOTTD Traineeship (a visiting scholar and mentorship program)
The EOTTD aims at improving the management for patients with GTD in all European countries. This goal is accomplished through a variety of activities. Since there are differences in the development of centres dedicated to the treatment of GTD within Europe, EOTTD wants to introduce a new program providing trainees and early career specialists an opportunity to visit and witness the working of more established units so they may identify improved resource utilization in their own setting.

In this way EOTTD is creating opportunities for trainees/early career professionals to visit more established centres with specific goals of seeking mentorship.

Topics that can be learned in this program:

o    Multidisciplinary team management and governance

o    The diagnostic process in GTD

o    Research and clinical trial design

o    Proper hCG management

o    Treatment of high and ultrahigh risk patients

o    Pathology and Genetics in GTD

The duration of the traineeship is 1-2 weeks, and the maximum number of yearly positions is four. Centres that can be visited are London, Sheffield, Amsterdam/Nijmegen, Lyon and Stockholm. EOTTD will give financial support to every approved traineeship with 500 euros. The applicant should present his/her resume and the goal(s) of the proposed visit to the EOTTD board as part of the application process.

Selected publications on GTD 2023
·         Treatments and outcomes in high-risk gestational trophoblastic neoplasia: a systematic review and meta-analysis.
Albright BB, Ellett T, Knochenhaur HE, Goins EC, Monuszko KA, Kaplan SJ, Previs RA, Moss HA, Havrilesky LJ, Davidson BA.
BJOG. 2023 Jan 17. PMID: 36648416

·         EMACO for treatment of gestational trophoblastic neoplasia: A multinational multicenter study.
Jareemit N, Therasakvichya S, Freitas F, Paiva G, Ramírez LAC, Berkowitz RS, Horowitz NS, Maestá I, Fülöp V, Braga A, Elias KM.
Gynecol Oncol. 2023 Jan 20;170:114-122. PMID: 36682089

·         Evaluation of a web-based intervention for patients with Gestational Trophoblastic Disease: a randomized controlled trial.
Frijstein M, Blok L, Ten Kate Booij M, Eysbouts Y, Trommel NV, Sweep F, Massuger L, V Hamont D, Schreuder H, Smink M, Molkenboer J, Vencken P, Ottevanger N, Lok C.
Gynecol Obstet Invest. 2023 Jan 20. PMID: 36682348

·         Avelumab in patients with gestational trophoblastic tumors with resistance to polychemotherapy: Cohort B of the TROPHIMMUN phase 2 trial.
You B, Bolze PA, Lotz JP, Massardier J, Gladieff L, Floquet A, Hajri T, Descargues P, Langlois-Jacques C, Bin S, Villeneuve L, Roux A, Alves-Ferreira M, Grazziotin-Soares D, Dherret G, Gerentet C, Rousset P, Freyer G, Golfier F.
Gynecol Oncol. 2023 Jan;168:62-67. PMID: 36401942

·         PREDICT-GTN 1: Can we improve the FIGO scoring system in gestational trophoblastic neoplasia?
Parker VL, Winter MC, Tidy JA, Hancock BW, Palmer JE, Sarwar N, Kaur B, McDonald K, Aguiar X, Singh K, Unsworth N, Jabbar I, Pacey AA, Harrison RF, Seckl MJ.
Int J Cancer. 2023 Mar 1;152(5):986-997. PMID: 36346113

Upcoming EOTTD publications
o    Special issue in Gynecology and Obstetrics in 2023
Planned chapters:

1. Editorial
2. The development of hcg testing and the need for reference laboratories.
3. Expert pathology for GTD: towards a international multidisciplinary MDT.
4. Exposure and centralization of GTD care: the elephant in the room.
5. Immunotherapy for GTN: why and when it works.
6. Consequences of GTD treatment for patients
7. Surgical treatment of GTD
8. From national to international collaboration in GTD: hurdles and possibilities
9. Why to consult a geneticist in GTD
10. The rare if the rarest: PSTT, ETT, APSN
11. Controversies in GTN (describing the debates)
12. Mismanagement of GTN (10 cases of not well handled GTN)