Chemotherapy using 5-fluorouracil and nitrocaphanum in malignant trophoblastic tumor

The aim of this study was to investigate the efficacy of nitrocaphanum (AT 1258) in combination with 5-fluorouracil (5-FU) in patients with gestational trophoblastic tumors (GTT).

From 1979 to 1988, 152 patients with trophoblastic tumor were treated with combination chemotherapy using nitrocaphanum and 5-FU. Seventy patients had nonmetastatic disease, 61 with single organ metastasis and 9 with involvement of two or more organs. Fifty patients had received previous chemotherapy. The dose of 5-FU was 26 mg/kg and that of nitrocaphanum 0.6 mg/kg each daily for 8 days, repeated every 29 days.

Among patients who received nitrocaphanum with 5-FU, 134 of 152 patients (88%) achieved remission. By World Health Organization risk groups, the response to nitrocaphanum was as follows: 5-FU was 93.6% of 94 low-risk patients, 81.4% of 46 medium-risk patients, and 73.3% of 15 high-risk patients. Eighteen patients had to be given a second-line protocol because of resistance to nitrocaphanum and 5-FU. Fourteen of the 18 were cured while 4 patients died. There were 7 late recurrences more than 3 months after completion of therapy and 6 of these were cured by hysterectomy and chemotherapy.

Nitrocaphanum is an active chemotherapy agent in GTT and deserves further study for possible use in high-risk, chemotherapy-resistant patients.