What is your approach to first line systemic treatment for low risk gestational trophoblastic neoplasia?

Patients with gestational trophoblastic disease and a WHO score < 6 are classified as low risk. In patients who desire retention of fertility, the first line treatment is chemotherapy which achieves typically very high remission rates/cure rates. The most frequently used first line regimens employ m...

I use actinomycin D in patients with transportation issues (i.e., living out of town) since it is administered every two weeks. The remission rate is comparable to MTX.

These are remission data I found for low risk GTN treatment options:

1. Methotrexate - 1 mg/kg IM day 1, 3, 5, 7. Folinic acid 0.1 mg...