A woman treated for high-risk gestational trophoblastic neoplasia with EMA-CO becomes resistant. Which salvage regimen is most commonly employed as second-line treatment?
- A EMA-EP (etoposide-methotrexate-actinomycin-D with etoposide-cisplatin) ✓
- B BEP (bleomycin-etoposide-cisplatin)
- C VIP (vinblastine-ifosfamide-cisplatin)
- D FOLFOX
Correct answer: A. EMA-EP (etoposide-methotrexate-actinomycin-D with etoposide-cisplatin)
Explanation
For EMA-CO resistant or relapsed GTN, the standard salvage regimen is EMA-EP, where the CO component (cyclophosphamide + vincristine/oncovin) is replaced with EP (etoposide + cisplatin). EMA-EP produces remission in approximately 75–80% of EMA-CO resistant cases. BEP is used for germ cell tumours; VIP is an alternative germ cell salvage; FOLFOX is used for colorectal cancer.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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