Which chemotherapy regimen is the standard first-line treatment for high-risk gestational trophoblastic neoplasia (FIGO/WHO score 7 or more)?
- A EMA-CO ✓
- B Single-agent methotrexate with folinic acid rescue
- C BEP (bleomycin, etoposide, cisplatin)
- D Paclitaxel and carboplatin
Correct answer: A. EMA-CO
Explanation
High-risk GTN requires multiagent chemotherapy, conventionally EMA-CO comprising etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (oncovin). Single-agent methotrexate or actinomycin D is reserved for low-risk disease and would be inadequate here, risking chemoresistance. BEP is the standard for germ cell tumours of the ovary, not GTN, and platinum doublets play no established role in first-line trophoblastic disease.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.