Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6): lines of therapy
5 standard-of-care settings across 3 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Screening, prevention and diagnosis
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Diagnosis and staging | Serial hCG after molar evacuation; pelvic Doppler ultrasound and chest X-ray or CT; FIGO scoring; no biopsy needed. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 40 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | First line | Single-agent methotrexate with folinic acid (eight-day regimen) or pulsed actinomycin D (GOG 174), continued until hCG normalises plus three consolidation cycles. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 94 | |
| All comers | Resistance to first agent | Switch to the alternative single agent if hCG is low; EMA-CO if hCG is high; avelumab or pembrolizumab as chemotherapy-sparing options (TROPHIMMUN). | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 98 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Surgery | Second uterine evacuation in selected women with low hCG; hysterectomy for women who have completed their families or with uncontrolled bleeding. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 32 | |
| All comers | Follow-up | hCG monitoring for twelve months after remission, contraception during follow-up, and hCG after every future pregnancy. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | - |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.