While anti-cancer drugs may lessen the risk of developing gestational trophoblastic neoplasia (GTN) in women with complete molar pregnancies who are at a high risk for such, they also increase drug resistance, GTN treatment delays, and adverse events, according to a Cochrane review of 3 randomized trials involving 613 women. 2 studies tested methotrexate and 1 evaluated dactinomycin in women with complete remission. The latter study looked at women at high risk of getting GTN. Among the findings:

• The drugs reduce the number of women developing cancer after molar pregnancy, but this is likely true for women with high-risk moles.
• The medications might delay cancer diagnosis and increase the number of anti-cancer treatments needed if it develops.
• Short- and long-term adverse events could not be ascertained.

The authors concluded that given the possibility of drug resistance, treatment delay, and side effects, anticancer drugs in this setting are not recommended.