Gestational trophoblastic disease - clinical prediction and exploration of the immune cell landscape

Thursday 25 May 2023, 12:30 pm
PhD student
Y.M. Hoeijmakers MSc.
prof. dr. C.G.J. Sweep, prof. dr. I.J.M. de Vries, prof. dr. L.F.A.G. Massuger
dr. P.B. Ottevanger, dr. Y.K. Roos-Eysbouts

Gestational trophoblastic disease (GTD) comprises a group of pre-malignant and malignant pregnancy related disorders originating from placental tissue. In some patients, pre-malignant disease progresses to malignant disease, necessitating treatment (usually chemotherapy). Trophoblast activity is monitored by measuring serum human chorionic gonadotropin (hCG) levels. In this thesis, we developed a method to estimate individualized risk of disease progression and subsequent need of chemotherapy. For patients failing first-line therapy with methotrexate, hCG cut-offs were formulated to determine which type of second-line chemotherapy is appropriate. In addition, we describe immunological mechanisms which proliferating, malignant trophoblast cells may use to evade immune responses in order to select patients who may  benefit from recently introduced immunotherapy. The ultimate aim of this thesis is to shorten treatment duration and to reduce exposure to treatment related toxic side-effects, thereby creating an earlier opportunity to pursue a new (healthy) pregnancy.

Yvonne Hoeijmakers (1990) received her master’s degree in medicine at the Radboud University in 2016. After graduation she started working as a resident in Obstetrics and Gynecology. In 2018, after her second year of residency she paused her residency for two years and started her PhD trajectory in Gestational trophoblastic diseases. In 2020 she continued her residency in Obstetrics and Gynecology and is currently working at the Radboud university medical center in Nijmegen.