Skip to content

Cervical Cancer Health Center

Font Size

Gestational Trophoblastic Disease Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent or Chemoresistant Gestational Trophoblastic Neoplasia Treatment

Recurrent disease indicates failure of prior chemotherapy unless initial therapy was surgery alone. One study found recurrence of disease in 2.5% of patients with nonmetastatic disease, 3.7% of patients with good-prognosis metastatic disease, and 13% of patients with poor-prognosis metastatic disease.[1] Nearly all recurrences occur within 3 years of remission (85% before 18 months). A patient whose disease progresses after primary surgical therapy is generally treated with single-agent chemotherapy unless one of the poor-prognosis factors that requires combination chemotherapy supervenes. Relapse after prior chemotherapy failure automatically places the patient into the high-risk category. These patients should be treated with aggressive chemotherapy.

Reports of combination chemotherapy come from small retrospective case series. Long-term disease-free survival, in excess of 50%, is achievable with combination drug regimens.[2][Level of evidence: 3iiiDii] A variety of regimens have been reported that include combinations of the following:[3,4,5,6,7]

Recommended Related to Cervical Cancer

Understanding Cervical Cancer -- Prevention

Since infection with human papillomavirus (HPV) is the most important risk factor for cervical cancer and precancers, it is important to avoid genital HPV infection. This may mean delaying sex, limiting the number of sex partners, and avoiding a sex partner who has had several other partners. Condoms are important to prevent the spread of sexually transmitted diseases, but they can't give full protection against HPV since there may be skin to skin contact of exposed areas which can transmit the virus...

Read the Understanding Cervical Cancer -- Prevention article > >

A select group of patients with chemotherapy-resistant and clinically detectable gestational trophoblastic neoplasia may benefit from salvage surgery.[8][Level of evidence: 3iiiDii]

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent gestational trophoblastic tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

  1. Mutch DG, Soper JT, Babcock CJ, et al.: Recurrent gestational trophoblastic disease. Experience of the Southeastern Regional Trophoblastic Disease Center. Cancer 66 (5): 978-82, 1990.
  2. Newlands ES: The management of recurrent and drug-resistant gestational trophoblastic neoplasia (GTN). Best Pract Res Clin Obstet Gynaecol 17 (6): 905-23, 2003.
  3. Matsui H, Iitsuka Y, Suzuka K, et al.: Salvage chemotherapy for high-risk gestational trophoblastic tumor. J Reprod Med 49 (6): 438-42, 2004.
  4. Xiang Y, Sun Z, Wan X, et al.: EMA/EP chemotherapy for chemorefractory gestational trophoblastic tumor. J Reprod Med 49 (6): 443-6, 2004.
  5. Lurain JR, Nejad B: Secondary chemotherapy for high-risk gestational trophoblastic neoplasia. Gynecol Oncol 97 (2): 618-23, 2005.
  6. Wan X, Xiang Y, Yang X, et al.: Efficacy of the FAEV regimen in the treatment of high-risk, drug-resistant gestational trophoblastic tumor. J Reprod Med 52 (10): 941-4, 2007.
  7. Wang J, Short D, Sebire NJ, et al.: Salvage chemotherapy of relapsed or high-risk gestational trophoblastic neoplasia (GTN) with paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE). Ann Oncol 19 (9): 1578-83, 2008.
  8. Lehman E, Gershenson DM, Burke TW, et al.: Salvage surgery for chemorefractory gestational trophoblastic disease. J Clin Oncol 12 (12): 2737-42, 1994.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Public Information from the National Cancer Institute

    Last Updated: September 04, 2014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
    1
    Next Article:

    Today on WebMD

    cancer cell
    HPV is the top cause. Find out more.
    doctor and patient
    Get to know the Symptoms.
     
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    Lung cancer xray
    See it in pictures, plus read the facts.
     
    Integrative Medicine Cancer Quiz
    QUIZ
    Lifestyle Tips for Depression Slideshow
    SLIDESHOW
     
    Screening Tests for Women
    Slideshow
    what is your cancer risk
    HEALTH CHECK