The following article features coverage from the 46th Annual Oncology Nursing Society (ONS) Congress. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Patients with gestational trophoblastic disease (GTD) are at risk for developing gestational trophoblastic neoplasia (GTN), a rare form of disease. The treatment plan for GTD is based on patient-specific symptoms to prevent progression to GTN. These findings were presented in a poster during the 46th Annual Oncology Nursing Society (ONS) Congress.

Kathryn Johnson, DNP, MSc, FNP-BC, of the Icahn School of Medicine at Mount Sinai in New York, New York, searched publication databases for articles that discussed treatment and prevention strategies for progression or recurrence of GTD.

A total of 3 relevant systematic reviews were identified. These reports suggest first-line treatment for GTN and prophylactic treatment of GTD should be chemotherapy.


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The treatment strategy should start by determining whether GTD is present. For cases in which GTD is diagnosed, the patient should be evaluated for whether or not the GTD is novel or recurrent.

For novel diagnoses, the patient should undergo uterine evacuation and serum human chorionic gonadotropin (hCG) assessment. Prophylactic chemotherapy with methotrexate and dactinomycin (Actinomycin-D) is recommended.

For GTD recurrence, recommendations include uterine evacuation, serum hCG assessment, and first-line chemotherapy with methotrexate and dactinomycin. Second-line chemotherapy with dactinomycin or combination therapy is recommended. Surgery is also an option for patients with recurrent disease.

This condition is rare and available data is scarce. Nurses and nurse practitioners should be aware of these conditions and the overall lack of clinical data supporting best treatment practices. Patients should be treated on the specific disease characteristics they exhibit, concluded Dr Johnson.

Read more of Oncology Nurse Advisor‘s coverage of the 46th Annual ONS Congress by visiting the conference page.

Reference

Johnson K. Evaluating optimal treatment strategies to prevent the progression or recurrence of gestational trophoblastic disease (GTD) to malignant disease forms. Oncol Nursing Forum. 2021;48(2):abstr 9775.