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01-04-2019 | Gynecologic Oncology

Oral etoposide for metastatic choriocarcinoma: a case report and review of guidelines

Authors: Georg-Peter Breitbach, Panagiotis Sklavounos, Christian Veith, Serban-Dan Costa, Walther Kuhn, Erich-Franz Solomayer, Ingolf Juhasz-Boess, Clemens Tempfer

Published in: Archives of Gynecology and Obstetrics | Issue 4/2019

Abstract

Background and purpose

Choriocarcinoma (CCA) is a rare form of malignant trophoblastic disease. Systemic polychemotherapy with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA/CO) is the mainstay of treatment for metastatic disease. Due to the rarity of the condition, however, the evidence basis for this management is small and other chemotherapy regimens may also be effective. The reported case presents anecdotal evidence of an effective etoposide monotherapy treatment.

Method: case presentation

We report the case of a patient with gestational choriocarcinoma and pulmonary metastases initially treated with methotrexate. Due to local disease progression, she underwent hysterectomy and continued treatment with methotrexate. After pulmonary progression, she was switched to oral etoposide.

Results

After four cycles of etoposide monotherapy at a oral dosage of 100 mg d1–7, q28, the patient had no evidence of disease according to human chorionic gonadotropin serum levels and imaging studies. The treatment was well tolerated with World Health Organization (WHO) grade 2 alopecia and hot flushes as the most prominent side effects. The patient has achieved a sustained complete remission with a follow-up of 6 years.

Conclusion

Oral etoposide may be an effective treatment alternative to EMA/CO in selected patients with oligometastatic CCA.

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Title: Oral etoposide for metastatic choriocarcinoma: a case report and review of guidelines
Authors: Georg-Peter Breitbach
Panagiotis Sklavounos
Christian Veith
Serban-Dan Costa
Walther Kuhn
Erich-Franz Solomayer
Ingolf Juhasz-Boess
Clemens Tempfer
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 4/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-018-5016-x

ACC 2024 Congress

Springer Medicine

Oral etoposide for metastatic choriocarcinoma: a case report and review of guidelines

Abstract

Background and purpose

Method: case presentation

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background and purpose

Method: case presentation

Results

Conclusion

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