Ectopic pregnancy project announced in NHMRC’s ’10 of the best’ for 2015

A collaborative research project that has led to a more effective non-surgical treatment for ectopic pregnancy has been named one of the NHMRC’s ‘10 of the Best’ research projects of 2015.

The project, funded by an NHMRC Project Grant (2011-2013) has involved Professor Terry Johns, Professor Andrew Horne (University of Edinburgh) Professor Stephen Tong and Dr Monika Skubisz (both now at the University of Melbourne).

In 2012, in lab experiments at Hudson Institute (previously MIMR), Professor Johns and Professor Tong identified that a drug called gefitinib could be added to methotrexate, a drug currently used to treat ectopic pregnancy.

This discovery has now led to Phase III clinical trials for a new non-surgical treatment for ectopic pregnancy, which is a combination of the two drugs.

Ectopic pregnancy is a complication affecting around one in every 100 births. It occurs when the embryo attaches outside of the uterus, and can be life-threatening.

Professor Johns said his initial collaboration with Professor Tong, and the eventual and unlikely fusion of the two drugs, came about through conversations and sharing a lab space.

“Gefitinib is a drug normally used to treat lung cancer. However, the placenta also contains large amounts of the epidermal growth factor receptor, which is what gefitinib is used to target and suppress,” Professor Johns said.

Currently, most ectopic pregnancies are treated surgically. While the surgery for ectopic pregnancy is safe, there are risks associated with any surgical treatment.

In cases where the ectopic pregnancy is small, methotrexate can be used to clear the ectopic pregnancy medically, but the combination drug is being shown to be a more effective treatment.

A Phase I clinical trial in 2013 involving 12 women at Monash Health and in Edinburgh confirmed this hypothesis, showing the combination treatment was 34 per cent more effective than methotrexate alone in clearing ectopic pregnancy.

A second trial clinical trial took place in Edinburgh and Melbourne involving 36 patients. The combination drug successfully cured ectopic pregnancy outside the fallopian tubes in a subset of eight of these patients.

A Phase III randomised control placebo clinical trial is now underway in 25 to 50 hospitals in the UK, under the supervision of Professor Tong and Professor Horne.

“We hope this treatment will allow women to avoid surgery, and enhance their chances of a future healthy pregnancy,” Professor Johns said.