Gestational Trophoblastic Tumors Treatment (PDQ®)
Cancer Information Summaries « English « Health professionals « G
Good-Prognosis Metastatic Gestational Trophoblastic Tumors
This group of patients has disease outside the uterus, but it does not have any of the adverse prognostic factors detailed in stage information. In general, these patients should be treated with single-agent chemotherapy as described for nonmetastatic disease. Patients who do not tolerate methotrexate or who become resistant to it can often be salvaged with dactinomycin. Development of intercurrent poor-risk factors dictates the need for combination chemotherapy. Cure rates should approach 100%, but approximately 40% to 50% of these patients will develop resistance to the first chemotherapeutic agent and require alternate treatment. Careful monitoring is mandatory.
Standard treatment options:
- Methotrexate with leucovorin. [1]
- Dactinomycin. Tumors of the placental trophoblast.
- Primary hysterectomy followed by single-agent chemotherapy with methotrexate or dactinomycin (if patient has completed family).
- Primary chemotherapy followed by secondary hysterectomy for persistent uterine disease (must verify that metastatic disease has totally regressed).
- For refractory disease:
- MAC: methotrexate plus dactinomycin plus chlorambucil. [2]
Other regimens appear to produce similar survival outcomes but have been studied less extensively or are in less common use. They are:
- Methotrexate. [2]
- EMA-CO: etoposide plus methotrexate plus dactinomycin and vincristine plus cyclophosphamide. [3]
Current Clinical Trials
Check for U.S. clinical trials from NCI’s PDQ Cancer Clinical Trials Registry that are now accepting patients with good prognosis metastatic gestational trophoblastic tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
References
Tumors of the placental trophoblast. In: Morrow CP, Curtin JP: Synopsis of Gynecologic Oncology. 5th ed. New York, NY: Churchill Livingstone, 1998, pp 315-353.
This record was last updated on December 5th, 2007.
About the PDQ Cancer Information Summaries from the National Cancer Institute
PDQ (Physician Data Query) is a comprehensive cancer database published by the National Cancer Institute (NCI), which is part of the National Institutes of Health (NIH). It contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care, and complementary and alternative medicine; a registry of cancer clinical trials; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care.
The PDQ Cancer Information Summaries are peer reviewed and updated monthly by six editorial boards comprised of specialists in adult treatment, pediatric treatment, supportive care, screening and prevention, genetics, and complementary and alternative medicine. The Boards review current literature from more than 70 biomedical journals, evaluate its relevance, and synthesize it into clear summaries. Many of the summaries are also available in Spanish.
Linked medical terms appearing on this page are added by Healia to help readers find more information and are not part of the original PDQ document.