Successful salvage treatment with paclitaxel, ifosfamide, and cisplatin in a patient with methotrexate-resistant gestational trophoblastic neoplasia who developed hypersensitivity reaction to etoposide

J Obstet Gynaecol Res. 2021 Oct;47(10):3737-3741. doi: 10.1111/jog.14945. Epub 2021 Jul 18.

Abstract

We report a 34-year-old woman with recurrent gestational trophoblastic neoplasia (GTN) who showed hypersensitivity to etoposide. Computed tomography (CT) revealed a 32-mm solid mass in the right lung and a 101-mm cystic mass with solid components in the left side of the liver. The patient's serum human chorionic gonadotropin (HCG) level was 689 439 mIU/mL. After eight cycles of combined paclitaxel 175 mg/m2 on day 1, ifosfamide 1 g/m2 on days 2-5, and cisplatin 20 mg/m2 on days 2-5 (TIP) every 3 weeks, the serum HCG level decreased to 2.4 mIU/mL. CT scan revealed disappearance of the lung tumor and significant reduction in the solid components of the liver tumor. Then, left hemihepatectomy was performed. After 3 months, there was no evidence of the disease, and the serum HCG level normalized. Thus, TIP chemotherapy, followed by residual mass resection, might be effective for methotrexate-resistant GTN.

Keywords: HCG; TIP therapy; hypersensitivity reactions to etoposide; methotrexate-resistant GTN; surgical resection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Cisplatin / adverse effects
  • Dactinomycin / therapeutic use
  • Drug Resistance, Neoplasm
  • Etoposide / therapeutic use
  • Female
  • Gestational Trophoblastic Disease* / drug therapy
  • Humans
  • Ifosfamide / adverse effects
  • Methotrexate* / adverse effects
  • Neoplasm Recurrence, Local / drug therapy
  • Paclitaxel / therapeutic use
  • Pregnancy
  • Salvage Therapy

Substances

  • Dactinomycin
  • Etoposide
  • Paclitaxel
  • Cisplatin
  • Ifosfamide
  • Methotrexate