Placental-site trophoblastic tumour and epithelioid trophoblastic tumour: lines of therapy
5 standard-of-care settings across 4 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 | Expert pathology with immunohistochemistry (human placental lactogen, p63, Ki-67) and genotyping; pelvic MRI, chest CT and FDG-PET; registration with a trophoblastic disease centre. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 95 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Metastatic disease or interval over four years | Multi-agent platinum-based chemotherapy (EP-EMA or TP/TE) with resection of residual disease; EMA-CO alone is insufficient. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 94 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Resistant disease | Surgical excision of chemoresistant deposits; high-dose chemotherapy with autologous stem cell rescue in selected cases; pembrolizumab in trials or on a case basis. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 98 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Disease confined to the uterus | Total hysterectomy with ovarian preservation; pelvic node sampling considered; fertility-sparing local resection only in exceptional cases with close follow-up. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 32 | |
| All comers | Follow-up | Clinical review with hCG and imaging, because hCG alone can miss recurrence; prolonged surveillance for late relapse. | NCCN Guidelines: Gestational Trophoblastic Neoplasia | 40 |
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.