NCCN Releases First Treatment Guideline for Rare Cancers Affecting Pregnant Women

The guidelines fill an unmet clinical need for a standard care consensus on gestational trophoblastic neoplasia, a group of rare cancers that affect pregnant women.

The National Comprehensive Cancer Network (NCCN) has released the first-ever treatment guidelines for gestational trophoblastic neoplasia (GTN), also known as gestational trophoblastic disease (GTD), a group of rare cancers that affect pregnant women.

Because of the condition’s rarity, health care providers are often unaware of how to best care for patients with GTN. According to the NCCN, the guidelines fill an unmet clinical need for a standardized treatment guideline for the uncommon disease.

“GTN can almost always be cured, but deviating from that standard can have severe consequences,” David Mutch, MD, who leads the NCCN Clinical Practice Guidelines in Oncology Committee for GTN, said in a press release. “Plus, by providing clear instructions for how best to treat GTN, we can streamline the insurance approval process for more efficient care.”

GTN, which occurs in approximately 1 out of 1000 pregnancies in the United States, happens when tumors develop in the cells that would normally form the placenta during pregnancy, according to the press release.

The guidelines provide treatment recommendations for several variations of the disease:

· For molar pregnancy, surgery is recommended as the first and often only treatment, performed via suction dilation and curettage.

· Low-risk GTN should be primarily treated with single-agent chemotherapy, but additional chemotherapy or surgery may be required for persistent disease.

· High-risk GTN treatment should involve multi-agent chemotherapy, with possible radiation therapy for brain metastasis.

· Surgery can be used for chemotherapy-resistant disease.

“These rare, potentially aggressive malignancies are highly curable,” Wui-Jin Koh, MD, chair of the NCCN Guidelines for Cervical, Uterine, and Vulvar Cancer, and incoming chief medical officer for NCCN, said in the press release. “That’s why it’s so important to correctly diagnose, treat, and monitor people with GTN.”

Appropriate treatment of GTN can help improve patients’ long-term outcomes while preserving fertility, Dr Koh added. Having expert consensus on treatment for this rare condition ensures that patients are receiving the most effective, standardized care for the variation of their disease.

“If someone with a rare type of cancer doesn’t live near one of the world’s experts on that disease, it doesn’t mean their treatment path can’t be based on that expertise,” Robert W Carlson, MD, chief executive officer of NCCN, said in the press release. “NCCN guidelines provide care recommendations for 97% of all cancer patients, plus numerous additional recommendations covering screening, prevention, and supportive care.”

Reference

NCNN Publishes First-Ever US Guidelines for Rare Cancers Associated with Pregnancy [news release]. NCNN’s website. https://www.nccn.org/about/news/newsinfo.aspx?NewsID=1122. Accessed August 10, 2018.