***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: We included one RCT of 42 women with high-risk GTN who were randomised to MAC (methotrexate, actinomycin D and chlorambucil) or the modified CHAMOCA regimen (cyclophosphamide, hydroxyurea, actinomycin D, methotrexate, doxorubicin, melphalan and vincristine). There were no statistically significant differences in efficacy of the two regimens; however women in the MAC group experienced statistically significantly less toxicity overall and less haematological toxicity than women in the CHAMOCA group. During the study period, six women in the CHAMOCA group died compared with one in the MAC group. This study was stopped early due to unacceptable levels of toxicity in the CHAMOCA group. We identified no RCTs comparing EMA/CO with MAC or other chemotherapy regimens. CHAMOCA is not recommended for GTN treatment as it is more toxic and not more effective than MAC. EMA/CO is currently the most widely used first-line combination chemotherapy for high-risk GTN, although this regimen has not been rigorously compared to other combinations such as MAC or FAV in RCTs. Other regimens may be associated with less acute toxicity than EMA/CO; however, proper evaluation of these combinations in high-quality RCTs that include long-term surveillance for secondary cancers is required. We acknowledge that, given the low incidence of GTN, RCTs in this field are difficult to conduct, hence multicentre collaboration is necessary.
Output:

We undertook this review to try to determine which combination/s of drugs are the most effective for the first-line drug treatment of high-risk GTN, and with the least side effects. We found only one small, older study that compared a drug combination abbreviated as CHAMOCA with one called MAC. The CHAMOCA regimen, which is no longer recommended for GTN treatment, was found to be extremely toxic to the blood and bone marrow, with no greater effect against the cancer than the MAC regimen. Based on the available evidence, it is currently not possible to determine whether EMA/CO is the most effective and least toxic drug combination as no high-quality studies have been conducted comparing this combination with other combinations. GTN is a rare cancer and so studies in this field are difficult to conduct, therefore researchers need to collaborate in order to produce the necessary high-quality evidence.