Frijstein MM, Lok CAR, van Trommel NE, et al. - Given the recent study in the Netherlands indicating a higher recurrence rate and more disease-specific death among Gestational Trophoblastic Neoplasia (GTN) patients with lung metastases vs patients without metastases, researchers sought to validate these findings in a different country. They conducted a historical cohort study at Charing Cross Hospital, United Kingdom including 1,040 low-risk GTN patients treated with Methotrexate between 2002 and 2016: 65 with lung metastases (group 1) and 975 without metastases (group 2). The analysis revealed a correlation of the presence of lung metastases at the start of methotrexate (MTX) therapy with a heightened incidence of MTX resistance and recurrence in low-risk GTN without influencing overall survival that remains 100%. However, resistance to MTX was more frequent among low-risk choriocarcinoma patients with lung metastases and consideration should be given to multi-agent chemotherapy.