LOW-RISK GESTATIONAL TROPHOBLASTIC NEOPLASIA: INSIGHTS FROM A TERTIARY CARE INSTITUTE IN INDIA

Objective: To report clinical characteristics, treatment outcomes and chemotherapy-related toxicities in patients with low-risk GTN at tertiary care centre in India. 

Material and Methods: This retrospective observational study was conducted at the Department of Medical Oncology of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi over 2 years. The clinical and treatment information of every patient diagnosed with GTN between December 2021 and December 2023 were examined retrospectively in their medical records. Methotrexate (MTX) was administered with folinic acid (FA) rescue to low-risk GTN patients. EMA-CO, multiagent chemotherapy, was administered every two weeks to patients with low-risk GTN who were resistant to first-line chemotherapy.

Results: Only 35 of the 40 patients with low-risk GTN were able to be evaluated since five of them were lost to follow-up throughout the course of treatment.The study found that the majority of patients (71.4%) experienced a molar pregnancy before developing gestational trophoblastic neoplasia (GTN), with 91.4% developing GTN within the first 4 months. Of these, 32 patients achieved complete responses (91.4%)with MTX therapy, while 3 experienced treatment failure (8.5%). Following multiagent chemotherapy, all three ofthe patients who had not responded to initial MTX therapy experienced complete remission (CR). All patients with GTN who were at low risk had 100% overall survival (OS) and cure rates.

Conclusion: With a complete response (CR) rate of 91.4% and no serious side effects, the MTX regimen proved to be highly effective in treating women with low-risk GTN.