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Annals of Oncology Advance Access published online on May 2, 2008
Annals of Oncology, doi:10.1093/annonc/mdn181
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Salvage chemotherapy of relapsed or high-risk gestational trophoblastic neoplasia (GTN) with paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE)

J. Wang, D. Short, N. J. Sebire, I. Lindsay, E. S. Newlands, P. Schmid, P. M. Savage and M. J. Seckl*

Department of Health, Charing Cross Hospital Gestational Trophoblastic Disease Centre, Imperial College School of Medicine, Charing Cross Hospital, London, UK

* Correspondence to: Prof. M. J. Seckl PhD FRCP, Department of Medical Oncology, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK. Tel: +44-208-846-1421; Fax: +44-208-748-5665; E-mail: m.seckl{at}imperial.ac.uk

Objectives: To evaluate the efficacy and toxicity of paclitaxel and cisplatin alternating with paclitaxel and etoposide doublet regimen (TP/TE), for salvage of patients with high-risk gestational trophoblastic neoplasia (GTN).

Patients and methods: Twenty-four patients with GTN received TP/TE. Sixteen had failed previous chemotherapy including six with cisplatin-based regimens (group A) and eight changed to TP/TE because of prior treatment-induced toxic effects (group B).

Results: In group A, three patients (19%) achieved a complete response (CR) and five (31%) a partial response (PR). All CR and four PR patients remain alive with a median follow-up of 25 months (range 9–48). The eight patients failing TP/TE subsequently died. Thus, the overall survival of the 16 patients in group A was 44% (seven of 16), rising to 70% (seven of 10) if the six patients who had failed prior cisplatin-based chemotherapy were excluded. In group B, four patients were assessable for response (two CR, two PR) and six remain alive (median follow-up 19 months) giving an overall survival of 75%. TP/TE was well tolerated, with only one patient discontinuing therapy because of toxic effects.

Conclusion: TP/TE is an effective, well-tolerated, salvage treatment for relapsed patients who are heavily pretreated for GTN. Further studies of this regimen are warranted.

chemotherapy, gestational trophoblastic neoplasia

Received for publication January 18, 2008. Revision received March 29, 2008. Accepted for publication March 31, 2008.


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