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Updated: Jul 3, 2026

In Vitro Assays to Evaluate the Migration, Invasion, and Proliferation of Immortalized Human First-trimester Trophoblast Cell Lines
Published on: March 5, 2019
Pulse methotrexate versus pulse actinomycin D in the treatment of low-risk gestational trophoblastic neoplasia
Fariba Yarandi1, Zahra Eftekhar, Hadi Shojaei
1Department of Gynecological Oncology, Medicine School, Medical Sciences/University of Tehran, Tehran, Iran. Fariba_Yarandi@Yahoo.com
Objective:
To compare the efficacy of methotrexate and actinomycin D as single agents in first-line chemotherapy for women with low-risk gestational trophoblastic neoplasia (LR-GTN).
Methods:
A total of 131 women with LR-GTN were randomized to receive a weekly pulsed dose of 30 mg/m(2) of methotrexate intramuscularly (n=81) or a pulsed intravenous bolus of 1.25 mg/m(2) of actinomycin D every 2 weeks (n=50). An additional cycle was administered as consolidation treatment following normalization of the serum level of beta-human chorionic gonadotropin (<5 IU/L).
Results:
Complete remission was achieved in 48.14% of patients in the methotrexate group and 90.00% in the actinomycin D group (P<0.001). The mean number of treatment cycles needed to achieve response was lower in the actinomycin D group (4.8 vs 6.8). The risk of treatment failure was 26.4 greater with methotrexate than with actinomycin D (95% confidence interval, 5.7-22.6; P<0.001).
Conclusion:
Actinomycin D may be a better option than methotrexate as a first-line chemotherapy agent for patients with LR-GTN.
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