The majority of gestational trophoblastic neoplasia (GTN) responds extremely well to first-line, multiagent chemotherapy employing etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO). However, up to 30% of patients develop either resistance or recurrence. Although EMA-CO resistant GTN is a relatively rare disease, it can be challenging to manage. The cure rate to such a condition is highly dependent on the availability of an effective multiagent chemotherapy regimen with reasonable toxicity profile. Close monitoring of high-risk patients, early diagnosis and recognition is key for a successful outcome. Despite the primary role of chemotherapy in EMA-CO resistant disease, surgical interventions have been shown to improve survival and cure rate. A variety of multiagent chemotherapy regimens have shown efficacy in EMA-CO resistant disease. Unfortunately, to date, there is no strong evidence to suggest which regimen is the standard second-line therapy. Many patients require multiple regimens with or without surgery to achieve complete remission. Early and appropriate intervention is crucial to maximize the chance of cure. The aim of this review article is developing a comprehensive clinical guide for management of EMA-CO resistant GTN.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.