A 26-year-old woman has choriocarcinoma with FIGO score of 7 (high risk) — lung metastases, post-term gestational event, and hCG 55,000 IU/L. According to EMA-CO regimen, the 'CO' component consists of which drugs?
- A Carboplatin and Oxaliplatin
- B Cisplatin and Ocreotide
- C Cyclophosphamide and Oncovin (vincristine) ✓
- D Cyclophosphamide and Oxaliplatin
Correct answer: C. Cyclophosphamide and Oncovin (vincristine)
Explanation
EMA-CO is the standard first-line chemotherapy for high-risk gestational trophoblastic neoplasia (FIGO score ≥ 7). The components are: E = Etoposide, M = Methotrexate, A = Actinomycin-D (given days 1–2), and CO = Cyclophosphamide + Oncovin (vincristine) given on day 8. The regimen alternates weekly. EMA-CO achieves complete remission in approximately 75–85% of high-risk GTN cases. For EMA-CO-resistant disease, EMA-EP (replacing CO with Etoposide-Platinum) is the salvage regimen. Folinic acid rescue must be given after methotrexate to prevent mucositis.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.