Current Clinical Trials

This is the most common presentation of gestational trophoblastic tumors and usually requires treatment with cytotoxic therapy, primarily single agents.

Standard treatment options:

Treatment usually consists of single-agent chemotherapy though hysterectomy has been used in the occasional patient where preservation of reproductive function is not an issue. Single-agent chemotherapy is usually methotrexate unless the patient has abnormal liver function, in which case dactinomycin is used.

1. Methotrexate with leucovorin.[1]
2. Dactinomycin.[2]

Other regimens appear to produce similar survival outcomes but have been studied less extensively or are in less common use. They are:

1. Methotrexate.[2-4]
2. Etoposide.[5]

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with nonmetastatic gestational trophoblastic tumor ¹. 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 ².

References

1. Berkowitz RS, Goldstein DP, Bernstein MR: Ten year's experience with methotrexate and folinic acid as primary therapy for gestational trophoblastic disease. Gynecol Oncol 23 (1): 111-8, 1986.  [PUBMED Abstract]
   
   
2. Tumors of the placental trophoblast. In: Morrow CP, Curtin JP: Synopsis of Gynecologic Oncology. 5th ed. New York, NY: Churchill Livingstone, 1998, pp 315-353. 
   
   
3. Homesley HD, Blessing JA, Rettenmaier M, et al.: Weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease. Obstet Gynecol 72 (3 Pt 1): 413-8, 1988.  [PUBMED Abstract]
   
   
4. Homesley HD, Blessing JA, Schlaerth J, et al.: Rapid escalation of weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease: a Gynecologic Oncology Group study. Gynecol Oncol 39 (3): 305-8, 1990.  [PUBMED Abstract]
   
   
5. Wong LC, Choo YC, Ma HK: Primary oral etoposide therapy in gestational trophoblastic disease. An update. Cancer 58 (1): 14-7, 1986.  [PUBMED Abstract]