Difference between revisions of "Gestational trophoblastic neoplasia"
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==ESMO== | ==ESMO== | ||
*'''2013:''' Seckl et al. [https://www.esmo.org/Guidelines/Gynaecological-Cancers/Gestational-Trophoblastic-Disease Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up] | *'''2013:''' Seckl et al. [https://www.esmo.org/Guidelines/Gynaecological-Cancers/Gestational-Trophoblastic-Disease Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up] | ||
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| + | ==[https://www.nccn.org/ NCCN]== | ||
| + | *[https://www.nccn.org/professionals/physician_gls/pdf/gtn.pdf NCCN Guidelines - Gestational Trophoblastic Neoplasia] | ||
=Low-risk disease, all lines of therapy= | =Low-risk disease, all lines of therapy= | ||
Revision as of 14:37, 18 November 2018
| Section editor | |
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Summer B. Dewdney, MD Chicago, IL |
4 regimens on this page
6 variants on this page
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Guidelines
ESMO
- 2013: Seckl et al. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
NCCN
Low-risk disease, all lines of therapy
Dactinomycin monotherapy
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Regimen
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Osborne et al. 2011 (GOG 0174) | Phase III (E) | Methotrexate | Seems to have superior CR rate |
Chemotherapy
- Dactinomycin (Cosmegen) 1.25 mg/m2 IV push once every 2 weeks
Treatment continued "until the βhCG assay had reached the institutional normal, or until either a rise or plateau in the βhCG level was observed"
References
- GOG 0174: Osborne RJ, Filiaci V, Schink JC, Mannel RS, Alvarez Secord A, Kelley JL, Provencher D, Scott Miller D, Covens AL, Lage JM. Phase III trial of weekly methotrexate or pulsed dactinomycin for low-risk gestational trophoblastic neoplasia: a Gynecologic Oncology Group study. J Clin Oncol. 2011 Mar 1;29(7):825-31. Epub 2011 Jan 24. link to original article link to PMC article contains verified protocol PubMed
Methotrexate monotherapy
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Regimen
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Osborne et al. 2011 (GOG 0174) | Phase III (C) | Dactinomycin | Seems to have inferior CR rate |
Chemotherapy
- Methotrexate (MTX) 30 mg/m2 IM once per week
Treatment continued "until the βhCG assay had reached the institutional normal, or until either a rise or plateau in the βhCG level was observed"
References
- GOG 0174: Osborne RJ, Filiaci V, Schink JC, Mannel RS, Alvarez Secord A, Kelley JL, Provencher D, Scott Miller D, Covens AL, Lage JM. Phase III trial of weekly methotrexate or pulsed dactinomycin for low-risk gestational trophoblastic neoplasia: a Gynecologic Oncology Group study. J Clin Oncol. 2011 Mar 1;29(7):825-31. Epub 2011 Jan 24. link to original article link to PMC article contains verified protocol PubMed