Gestational Trophoblastic Neoplasia Medication

Updated: Mar 05, 2015
  • Author: Enrique Hernandez, MD, FACOG, FACS; Chief Editor: Warner K Huh, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to eradicate the neoplasm.

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Antineoplastics

Class Summary

Gestational trophoblastic tumors are sensitive to many antineoplastic agents, especially those that act in the S phase or the M phase of the cell cycle.

Methotrexate (Folex PFS, Rheumatrex)

Used both as single agent and in multiagent regimens for the treatment of malignant GTN.

Actinomycin D (Dactinomycin)

Intercalates between guanine and cytosine base pairs, inhibiting DNA and RNA synthesis and protein synthesis. Use as single agent or as part of multiagent regimen for treatment of malignant GTN.

Cyclophosphamide (Cytoxan, Neosar)

Chemically related to nitrogen mustards. As alkylating agent, mechanism of action of active metabolites may involve cross-linking of DNA, which may interfere with growth of normal and neoplastic cells. Part of multiagent chemotherapy regimens used to treat high-risk metastatic GTN.

Etoposide (Toposar, VePesid)

Inhibits topoisomerase II and causes DNA strand breakage, causing cell proliferation to arrest in late S or early G2 portion of cell cycle. One of the drugs in multiagent chemotherapy regimens used to treat patients with high-risk metastatic GTN.

Vincristine (Oncovin, Vincasar PFS)

Blocks mitosis; one of the drugs included in multiagent chemotherapy regimens used to treat patients with high-risk metastatic GTN.

Cisplatin (Platinol)

Inhibits DNA synthesis and, thus, cell proliferation, by causing DNA cross-links and denaturation of double helix. Effective antineoplastic used in patients with chemotherapy-resistant malignant GTN.

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Chemotherapy modulating agent

Class Summary

May be used to alleviate toxic adverse effects of MTX. MTX blocks conversion of uridine to thymidine, one of the building blocks of DNA. Folinic acid provides a methyl group to uridine monophosphate, thus forming thymidine monophosphate, overcoming effects of MTX on tetrahydrofolic acid reductase.

Leucovorin (Wellcovorin)

Used to prevent toxicity from high doses of MTX.

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