PMID: 30027717May 1, 2017Paper

Role of Capecitabine in the Management of Gestational Trophoblastic Neoplasia: A Drug for Two Settings

The Journal of Reproductive Medicine
M BianconiG Jankilevich

Abstract

OBJECTIVE: To evaluate the role of capecitabine in the management of gestational trophoblastic neoplasia (GTN). STUDY DESIGN: The medical records of 155 patients with GTN were reviewed. All patients were treated and followed at our center. RESULTS: All patients were scored and stratified with the FIGO 2000 staging and risk factor scoring system for gestational trophoblastic disease. In the low-risk group (118 patients), 4 selected patients received capecitabine as second line of treatment, with a 75% response rate and long-term disease-free survival, and 1 of those patients needed EMA/CO to achieve cure. The cure rate was 100%. In the high-risk group 37 patients were reviewed. Capecitabine was indicated after EMA/CO or EMA/PE failure in the second, third, or sixth line. Six patients received capecitabine, with a 50% response rate, and remain as long-term survivors. Two patients who progressed with capecitabine were cured with TP/TE and EMA/PE regimens. One patient was refractory to all lines of chemotherapy. CONCLUSION: The use of capecitabine avoids multi-ple drug schemes and further toxicity for patients with curative disease, where long-term effects of therapy should be considered a second target. Its convenient oral rout...Continue Reading

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