In English | En español
Questions About Cancer? 1-800-4-CANCER

Gestational Trophoblastic Disease Treatment (PDQ®)

  • Updated: 04/25/2014

Table 2. Specifics of the EMA/CO Regimena,b,c

Day Drug Dose 
1Etoposide100 mg/m2 IV for 30 min
Dactinomycin0.5 mg IV push
Methotrexate300 mg/m2 IV for 12 h
2Etoposide100 mg/m2 IV for 30 min
Dactinomycin0.5 mg IV push
Folinic Acid15 mg or PO every 12 h × 4 doses, beginning 24 h after the start of methotrexate
8Cyclophosphamide600 mg/m2 IV infusion
Vincristine0.8–1.0 mg/m2 IV push (maximum dose 2 mg)

IV = intravenously; PO = orally.
aAdapted from Bower et al.[3]
bAdapted from Escobar et al.[4]
cAdapted from Lurain et al.[5]


  1. Bower M, Newlands ES, Holden L, et al.: EMA/CO for high-risk gestational trophoblastic tumors: results from a cohort of 272 patients. J Clin Oncol 15 (7): 2636-43, 1997.  [PUBMED Abstract]

  2. Escobar PF, Lurain JR, Singh DK, et al.: Treatment of high-risk gestational trophoblastic neoplasia with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy. Gynecol Oncol 91 (3): 552-7, 2003.  [PUBMED Abstract]

  3. Lurain JR, Singh DK, Schink JC: Management of metastatic high-risk gestational trophoblastic neoplasia: FIGO stages II-IV: risk factor score > or = 7. J Reprod Med 55 (5-6): 199-207, 2010 May-Jun.  [PUBMED Abstract]