This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Gestational Trophoblastic Disease, Subject name: Gynaecology & Obstetrics
EMA-CO regime of chemotherapy is used in the treatment of? 
Select and explain. 
A. Gestational trophoblastic neoplasia, B. Malignant Ovarian germ cell tumor, C. Endometrial carcinoma, D. CA cervix
A: Gestational trophoblastic neoplasia
Answer: A: Gestational trophoblastic neoplasia 
Explanation: Ans. A. Gestational trophoblastic neoplasiaPatients with high-risk tumors (high beta-hCG levels, disease presenting >=4 months after antecedent pregnancy, brain or liver metastasis, or failure of single-agent methotrexate) are initially treated with combination chemotherapy. EMA-CO (a cyclic non-cross-resistant combination of etoposide, methotrexate, and dactinomycin alternating with cyclophosphamide and vincristine); cisplatin, bleomycin, and vinblastine; and cisplatin, etoposide, and bleomycin are effective regimens. EMA-CO is now the regimen of choice for patients with high-risk disease because of excellent survival rates (>80%) and less toxicity.