Maesta I, et al. - This retrospective study provides information regarding the outcomes and toxicity of first-line methotrexate (MTX) chemotherapy in low-risk postmolar gestational trophoblastic neoplasia (GTN). At the New England Trophoblastic Disease Center (NETDC), low-risk postmolar GTN patients receiving 8-day methotrexate or one-day methotrexate infusion regimens were assessed and it was noted that 8-day MTX/FA was associated with more frequent treatment-related adverse events, although these were self-limited and resolved with no long-term sequelae. Given this and its higher effectiveness, 8-day MTX/FA continues to be the preferred treatment option at NETDC for patients with low-risk postmolar GTN.

• Between 1974 and 2014, researchers performed this retrospective cohort study at the New England Trophoblastic Disease Center (NETDC).
• This study included a total of 325 patients with FIGO-defined low-risk postmolar GTN receiving first-line 8-day MTX/folinic acid (FA) or one-day MTX infusion and FA.
• An assessment of demographics, disease presentation, initial treatment plan, treatment outcome, and treatment-related adverse events was carried out.

• For 8-day MTX/FA vs one-day MTX infusion, sustained remission (84% vs 62%, p < 0.001) and need to switch to second-line therapy due to treatment-related adverse events (5.3% vs 0%, p=0.001) were higher.
• With one-day MTX (34.5%) vs with 8-day MTX/FA (7.3%, p < 0.001), more frequent MTX resistance was observed.
• With both regimens, similar relapse rates were obtained (3.0%).
• Findings demonstrated that 8-day MTX/FA vs one-day MTX infusion was associated with significantly higher gastrointestinal disorders (48% vs 24%), abnormal laboratory findings (48% vs 28%), eye disorders (37% vs 19%) and general disorders (22% vs 5%) (p < 0.001).
• In addition, data reported that only infection frequency did not differ between 8-day MTX/FA and one-day MTX infusion (20% vs 12%, p=0.083).