title: Management of low-risk gestational trophoblastic tumors with etoposide (VP16) in patients resistant to methotrexate.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Milan, S. Raffaele Hospital Scientific Institute, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mangili
authors.forename: E
authors.initials: E
authors.lastname: Garavaglia
authors.forename: L
authors.initials: L
authors.lastname: Frigerio
authors.forename: G
authors.initials: G
authors.lastname: Candotti
authors.forename: A
authors.initials: A
authors.lastname: Ferrari
mesh_terms: 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*
chemical_list: D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide; D008727:Methotrexate