title: Etoposide-platin combination therapy for chemorefractory gestational trophoblastic disease.
abstract: The purpose of this study was to determine activity of etoposide-platin combination chemotherapy for chemorefractory gestational trophoblastic disease. A retrospective review of patients treated with etoposide-platin chemotherapy for chemorefractory trophoblastic disease was conducted. Patients received etoposide 100 mg/m2 and cisplatin 20 mg/m2 on Days 1 through 5 of 14- to 21-day cycles. Patient characteristics, responses, and toxicity were recorded. Seven women received etoposide-platin for chemorefractory disease. The median WHO prognostic index score upon initiation of therapy was 16 (range, 10-20) and patients had received a median 6 cycles of prior combination chemotherapy. Five patients developed grade IV neutropenia, four developed neutropenic sepsis, and two required platelet transfusions. Two patients developed significant deterioration of renal function. Six (86%) patients had complete responses, with normalization of hCG values, but only three (43%) patients with low pretherapy hCG levels have had sustained remissions. Etoposide-platin chemotherapy is an active regimen for the treatment of women with chemorefractory gestational trophoblastic disease but has significant hematologic and renal toxicity when used as salvage therapy. Future studies should investigate the incorporation of etoposide-platin into initial therapy of women with high-risk disease.
authors.affiliation: Division of Gynecologic Oncology, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Soper
authors.forename: A C
authors.initials: AC
authors.lastname: Evans
authors.forename: G
authors.initials: G
authors.lastname: Rodriguez
authors.forename: A
authors.initials: A
authors.lastname: Berchuck
authors.forename: D L
authors.initials: DL
authors.lastname: Clarke-Pearson
authors.forename: C B
authors.initials: CB
authors.lastname: Hammond
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012074:Remission Induction; D012189:Retrospective Studies; D014328:Trophoblastic Neoplasms / Q000188:drug therapy*; D014594:Uterine Neoplasms / Q000188:drug therapy*
chemical_list: D005047:Etoposide; D002945:Cisplatin