Dactinomycin More Effective Than Methotrexate for Treating Gestational Trophoblastic Neoplasia

A clinical study conducted on a population of women suffering from the low-risk cancer, gestational trophoblastic neoplasia (GTN), found that a biweekly dose of dactinomycin had a higher complete response rate than a weekly dose of methotrexate, the more commonly used drug.

In a study lasting eight years, investigators at the University of Texas Southwestern Medical Center (Dallas, USA) treated a group of 216 GTN patients with either biweekly intravenous dactinomycin or weekly intramuscular (IM) methotrexate.

Results published in the March 1, 2011, issue of the Journal of Clinical Oncology revealed that a biweekly dose of intravenous dactinomycin was superior to a weekly intramuscular injection of methotrexate in stopping the growth of cancerous cells in the uterus. Dactinomycin had a 70% complete response rate compared to 53% for methotrexate. Adverse effects were minimal with either drug.

"Both chemotherapy drugs are effective in treating this kind of neoplasia, but this trial proved that dactinomycin is the best first-line regimen," said contributing author Dr. David Scott Miller, professor of gynecologic oncology at the University of Texas Southwestern Medical Center.

"Minimizing toxicity is essential in low-risk GTN, because these women have a high-cure rate and usually hope to have subsequent pregnancies," Dr. Miller said. "These tumors are much more common in developing countries, where access to more complicated chemotherapy regimens is limited. We have sought to develop simpler but effective regimens that would lend themselves to use in low-resource settings."

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University of Texas Southwestern Medical Center