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etoposide + methotrexate + dactinomycin + cyclophosphamide + vincristine
- Development stage
- Unknown
- Lead developer
- Obstetrics and Gynecology Hospital of Fudan University
- Modality
- Small Molecules
- Administration
- Intravenous
01
Overview
EMA-CO is a multi-agent chemotherapy regimen consisting of etoposide, methotrexate, dactinomycin, cyclophosphamide, and vincristine. It is the standard-of-care treatment for patients with high-risk gestational trophoblastic neoplasia (GTN), typically defined by a WHO prognostic score of 7 or higher. The regimen is administered in a 14-day cycle: the EMA component (etoposide, methotrexate, and dactinomycin) is given on days 1 and 2, while the CO component (cyclophosphamide and vincristine) is given on day 8. This combination targets cancer cells through multiple mechanisms, including DNA strand breakage via topoisomerase II inhibition, depletion of folate pools, DNA intercalation, DNA alkylation, and inhibition of mitotic spindle formation. The Obstetrics & Gynecology Hospital of Fudan University is a key institution involved in the clinical application and research of this regimen for GTN.
- Other names
- EMA-CO regimenEMA/CO regimen
02
Targets
DHFR (Dihydrofolate reductase)TUBB (Tubulin (alpha and beta subunits))DNATOP2A (DNA topoisomerase II)
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