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Effectiveness of gefitinib in combination with methotrexate in the treatment of ectopic pregnancy

Authors Capmas P, Fernandez H

Received 18 March 2015

Accepted for publication 23 April 2015

Published 3 July 2015 Volume 2015:7 Pages 673—676


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Elie Al-Chaer

Perrine Capmas,1 Hervé Fernandez2

1Inserm, Centre of Research in Epidemiology and Population Health (CESP), 2Department of Gynecology, Bicetre Hospital, GHU Sud, AP-HP, Le Kremlin Bicêtre, France

Abstract: Medical management for ectopic pregnancy is subject to substantial variations with different protocols and various routes of administration. Regardless the protocol used, methotrexate is currently the medical treatment of choice for ectopic pregnancy. The risk of a rescue surgery is a main concern. Recently, some studies suggested combining gefitinib and methotrexate to improve medical treatment and to decrease the need for reinjection and for additional surgery. Gefitinib is an orally administered EGF receptor-tyrosine kinase inhibitor. For tubal ectopic pregnancy, median recovery time was shorter after combination treatment with gefitinib and methotrexate. Toxicity reported with combination treatment was acneiform rash in 67% of cases and diarrhea in 42%. They were always transient and are known side effects of gefitinib previously described in lung cancer. These preliminary results are very promising but need to be explored further before wide distribution. For ectopic pregnancy, combining treatment seems to be interesting but results of the first randomized trial have to be evaluated first. For other indications, such as non-tubal ectopic pregnancy or choriocarcinoma, randomized studies are needed before wide use of the combination in current practice.

Keywords: toxicity, efficacy, EGF receptor-tyrosine kinase inhibitor, non-tubal ectopic pregnancy

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