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.

Citation:

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.

This Week's Must Reads

Older patients with ccRCC may respond better to treatment than younger patients, Feulner et al. Urol Oncol. 2018 Nov 23. doi: 10.1016/j.urolonc.2018.11.006.

Still no validated biomarkers to select RCC treatment, D’Avella C et al. Urol Oncol. 2018 Nov 23. doi: 10.1016/j.urolonc.2018.10.027

DSS of ccRCC patients lower with high hTERT, Zanjani LS et al. Pathology. 2018 Nov 19. doi: 10.1016/j.pathol.2018.08.019.

ccRCC with papillary features best classified as a rare morphologic variant of ccRCC, Alaghehbandan R et al. Ann Diagn Pathol. 2018 Nov 22. doi: 10.1016/j.anndiagpath.2018.11.004.

SRS can effectively control brain metastases in patients with RCC, Wardak Z et al. Clin Genitourin Cancer. 2018 Nov 20. doi: 10.1016/j.clgc.2018.11.006.

Must Reads in Gynecologic Cancer

Uterine serous carcinoma patients have continuous high risk of VTE , Gressel GM et al. Obstet Gynecol. 2018 Oct 5;132:1130-6.

CD8+ Tumor-Infiltrating Lymphocytes and Ovarian Ca, JAMA Oncol; ePub 2017 Oct 12; OTTA Consortium

Lymph Node Removal During Endometrial Ca Surgery, Cochrane; 2017 Oct 2; Frost, Webster, et al

Cochrane on Reducing Neoplasia in Molar Pregnancy, Cochrane; 2017 Sep 11; Wang, Fu, Hu, et al

FDA Approves First Biosimilar to Treat Cancer, FDA news release; 2017 Sep 14