In the FIGO 2000 prognostic scoring for GTN, a patient scores 9 total. The FIRST-LINE chemotherapy regimen for this high-risk category is:

• A Single-agent methotrexate
• B Single-agent actinomycin-D
• C BEP (bleomycin, etoposide, cisplatin)
• D EMA-CO (etoposide, methotrexate, actinomycin-D, cyclophosphamide, vincristine) ✓

Explanation

A FIGO prognostic score ≥ 7 classifies GTN as high-risk, for which combination chemotherapy with EMA-CO is the international standard first-line treatment. This regimen achieves cure rates of approximately 85–90% even in advanced disease. Single-agent methotrexate or actinomycin-D is reserved for low-risk GTN (score ≤ 6). BEP is used for non-gestational germ cell tumours and resistant GTN, not as first-line for high-risk GTN.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.