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The Charing Cross series that established EMA/CO, an alternating weekly combination of five drugs, as the standard treatment for high-risk gestational trophoblastic disease, curing more than eight in ten women.
Retrospective analysis of 272 women with high-risk gestational trophoblastic tumours treated at Charing Cross Hospital with EMA/CO (etoposide, methotrexate and dactinomycin alternating weekly with cyclophosphamide and vincristine) between 1979 and 1995.
Five-year survival was about 86 percent, with complete remission in most and salvage of many who relapsed or were resistant using platinum-containing regimens and surgery; early deaths from disease and secondary leukaemia after etoposide were noted.
EMA/CO remains the first-line regimen for high-risk GTN worldwide; later Charing Cross work added low-dose induction etoposide-cisplatin for women with very high scores.
Shares Dactinomycin (actinomycin D), High-risk gestational trophoblastic neoplasia (FIGO score 7 or more, including ultra-high-risk), Methotrexate, Etoposide.
Shares Dactinomycin (actinomycin D), Methotrexate, Journal of Clinical Oncology.
Shares Methotrexate, Vincristine, Etoposide, Cyclophosphamide.
Shares Dactinomycin (actinomycin D), Vincristine, Cyclophosphamide.
Shares Dactinomycin (actinomycin D), High-risk gestational trophoblastic neoplasia (FIGO score 7 or more, including ultra-high-risk), Methotrexate, Vincristine.
Shares Methotrexate, Vincristine, Etoposide, Cyclophosphamide.
Shares Dactinomycin (actinomycin D), Vincristine.
Shares Vincristine, Etoposide, Cyclophosphamide.