Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cochrane on Reducing Neoplasia in Molar Pregnancy

Cochrane; 2017 Sep 11; Wang, Fu, Hu, et al

While anti-cancer drugs may lessen the risk of developing gestational trophoblastic neoplasia (GTN) in women with complete molar pregnancies who are at a high risk for such, they also increase drug resistance, GTN treatment delays, and adverse events, according to a Cochrane review of 3 randomized trials involving 613 women. 2 studies tested methotrexate and 1 evaluated dactinomycin in women with complete remission. The latter study looked at women at high risk of getting GTN. Among the findings:

  • The drugs reduce the number of women developing cancer after molar pregnancy, but this is likely true for women with high-risk moles.
  • The medications might delay cancer diagnosis and increase the number of anti-cancer treatments needed if it develops.
  • Short- and long-term adverse events could not be ascertained.

The authors concluded that given the possibility of drug resistance, treatment delay, and side effects, anticancer drugs in this setting are not recommended.


Wang Q, Fu J, Hu L, et al. Prophylactic chemotherapy for hydatidiform mole to prevent gestational trophoblastic neoplasia. Cochrane Database of Syst Rev. 2017, Issue 9. Art. No.: CD007289. doi:10.1002/14651858.CD007289.pub3.