April 5th, 2020

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Salvage Therapy of Extremely High-Risk and Resistant Gestational Trophoblastic Neoplasia with Gemcitabine, Oxaliplatin, and Paclitaxel: A Report of 3 Cases
Authors:  Yujie Huang, M.D., Jun Ying, M.D., Wei Zhao, M.D., and Jian-hua Qian, M.D.
BACKGROUND: In extremely high-risk gestational trophoblastic neoplasia (GTN) and resistant patients, EMA-CO and EP-EMA are used as first-line treatment. For patients who fail EMA-CO or EP-EMA, therapeutic options are very limited.
CASES: We report 3 cases of GTN classified as extremely high risk or resistant GTN. The patients all failed EMA-CO or EMA-EP regimen as well as additional standard chemotherapy. They were treated with gemcitabine, oxaliplatin, and paclitaxel regimen as salvage therapy. Two of the patients responded to the treatment.

CONCLUSION: Multiagent chemotherapy is the treatment of choice for extremely high-risk GTN and resistant patients. Gemcitabine, oxaliplatin, and paclitaxel regimen should be considered as a salvage therapy in patients after failing EMA-CO or EMA-EP regimen.
Keywords:  chemotherapy, gemcitabine, gestational trophoblastic disease, gestational trophoblastic neoplasia, high risk cases, hysterectomy, oxaliplatin, paclitaxel, salvage therapy, trophoblastic neoplasms
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