Effectiveness and toxicity of first-line methotrexate chemotherapy in low-risk postmolar gestational trophoblastic neoplasia: The New England Trophoblastic Disease Center experience

Gynecologic Oncology
Izildinha MaestáRoss S Berkowitz

Abstract

To assess the outcomes and toxicity of first-line methotrexate (MTX) chemotherapy in low-risk postmolar gestational trophoblastic neoplasia (GTN) patients receiving 8-day methotrexate or one-day methotrexate infusion regimens. This retrospective cohort study was conducted at the New England Trophoblastic Disease Center (NETDC), between 1974 and 2014, and included 325 patients with FIGO-defined low-risk postmolar GTN receiving first-line 8-day MTX/folinic acid (FA) or one-day MTX infusion and FA. Demographics, disease presentation, initial treatment plan, treatment outcome, and treatment-related adverse events were assessed. Sustained remission (84% vs 62%, p<0.001) and need to switch to second-line therapy due to treatment-related adverse events (5.3% vs 0%, p=0.001) were higher for 8-day MTX/FA compared to one-day MTX infusion. MTX resistance, however, was more frequent with one-day MTX (34.5%) than with 8-day MTX/FA (7.3%, p<0.001). Relapse rates were similar with both regimens (3.0%). Compared to one-day MTX infusion, 8-day MTX/FA was associated with significantly higher gastrointestinal disorders (48% vs 24%), abnormal laboratory findings (48% vs 28%), eye disorders (37% vs 19%) and general disorders (22% vs 5%) (p<0.001). ...Continue Reading

Citations

Mar 11, 2020·BMJ Open Ophthalmology·Clara M Castillejo BecerraAlexa Simon Meara
Sep 29, 2019·Cell Death & Disease·Chaoheng YuLi Yang
Jan 9, 2021·Obstetrics and Gynecology·John T Soper
Feb 11, 2021·Personalized Medicine·Manasawee SrisuttayasathienRuangsak Lertkhachonsuk
Jan 8, 2021·Cancer Management and Research·Dazun ShiYan Tian
Aug 11, 2021·Laboratory Investigation; a Journal of Technical Methods and Pathology·Shaobin WuDazun Shi
Jun 1, 2021·American Journal of Obstetrics and Gynecology·Benjamin B AlbrightLaura J Havrilesky

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