{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:42:03Z","timestamp":1791996123575,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,8,9]],"date-time":"2006-08-09T00:00:00Z","timestamp":1155081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2006,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The purpose of the study was to determine the activity and toxicity of pulse dactinomycin as salvage treatment of patients with low\u2010risk gestational trophoblastic neoplasia (GTN) who failed methotrexate therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Eligible patients had persistent\/recurrent low\u2010risk GTN defined by changes in serum human chorionic gonadotropin (hCG) levels (&lt;10% fall over 3 consecutive weekly titers, &gt;20% rise over the previous value, or a rise after attaining institutional normal [&gt;5 mu\/mL]); World Health Organization (WHO) score 2\u20136; Gynecologic Oncology Group (GOG) performance status 0\u20131; and previous treatment restricted to methotrexate. Dactinomycin administration was 1.25 mg\/m<jats:sup>2<\/jats:sup> intravenous (i.v.) every 2 weeks until documented complete response (CR) or treatment failure. CR was defined as an institutional normal serum hCG level sustained for \u22654 consecutive weeks; treatment failure was a &lt;10% fall (3 assays over 4 weeks) or &gt;20% rise (over previous value) in hCG serum level. Levels were monitored biweekly \u00d7 8 weeks beyond the first normal value, then monthly \u00d7 10.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Five of 44 enrolled patients were ineligible due to choriocarcinoma and normal pretreatment serum hCG level (2 each), no history of methotrexate (1), and 1 patient with documented phantom hCG syndrome was unevaluable. In all, 28 of 38 (74%) evaluable patients attained CR. The median number of cycles was 4 (range, 2\u201310). Severe toxicity was minimal, causing no patient to discontinue therapy. All treatment failures achieved a CR after receiving subsequent chemotherapy; 3 patients also underwent hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Pulse dactinomycin is an active regimen for patients withlow\u2010risk GTN who fail previous methotrexate therapy. Cancer 2006. \u00a9 2006 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.22118","type":"journal-article","created":{"date-parts":[[2006,8,9]],"date-time":"2006-08-09T17:18:29Z","timestamp":1155143909000},"page":"1280-1286","source":"Crossref","is-referenced-by-count":38,"title":["Phase II trial of pulse dactinomycin as salvage therapy for failed low\u2010risk gestational trophoblastic neoplasia"],"prefix":"10.1002","volume":"107","author":[{"given":"Allan","family":"Covens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia L.","family":"Filiaci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Burger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Osborne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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