Management of low-risk gestational trophoblastic tumors with etoposide (VP16) in patients resistant to methotrexate.
Careful selection and treatment monitoring of patients with gestational trophoblastic tumors (GTT) is critical because 20 - 50% of patients may develop a resistance and consequently require alternative chemotherapeutic agents. In our study we propose and demonstrate the efficacy of etoposide (VP16) as a second-line drug. An average of 5 courses with VP16 were used to achieve a remission in 12 patients resistant to MTX with low-risk GTT. Toxicity was mild and no resistance to VP16 was observed. A follow-up of 66 months (range, 22-109) has been performed for the patients and all of them are now disease free. Two patients had a pregnancy, respectively, 3 and 4 years after treatment. The others did not desire any pregnancy.
Mangili
G
G
Department of Obstetrics and Gynaecology, University of Milan, S. Raffaele Hospital Scientific Institute, Italy.
Garavaglia
E
E
Frigerio
L
L
Candotti
G
G
Ferrari
A
A
D000293:Adolescent; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D005047:Etoposide / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D011247:Pregnancy; D011379:Prognosis; D016896:Treatment Outcome; D014328:Trophoblastic Neoplasms / Q000188:drug therapy*
D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D008727:Methotrexate