Information at a glance

Flagship Initiative to Benefit Ectopic Patients

A project to test a novel medical treatment for ectopic pregnancies in humans has been announced as the second annual Flagship Project for MIMR. The team will be led by Dr Stephen Tong, Pregnancy and Maternal Health Group in the Ritchie Centre, and includes laboratory heads from across the Institute, including Professor Euan Wallace (Ritchie Centre), and Associate Professor Terry Johns (Centre for Cancer Research).

The Flagship Project initiative was introduced in 2008 by Institute Director, Professor Bryan Williams, who issued the challenge to identify a project of high scientific and medical significance that would result in major discoveries with the potential for significant positive outcomes for patients.

Approximately 2% of all pregnancies are ectopic, which in Victoria equates to 1,500 per year. Ectopic pregnancies are conceptions that implant in the fallopian tube, which can erode blood vessels causing life threatening bleeding. Currently most cases are treated with surgery, where commonly the entire tube is removed which can have implications on the woman’s fertility.

The clinical trials (phase I-II), due to start in the middle of this year, will test the efficacy of treating an ectopic pregnancy with a single injection of methotrexate, and a course of tablets taken for seven days. The tablet is gefitinib, a small molecule that blocks epidermal growth factor receptor. It is well tolerated and currently used in the clinic to delay cancer relapse.

The trial follows on from 18 months of pre-clinical work lead by Dr Tong, Dr Ulrika Nilsson and A/Prof Johns that shows placental tissue is exquisitely sensitive to this treatment combination. Thus, it is an exciting initiative that boldly takes a concept conceived at the MIMR laboratories into the clinic.

“We believe it may be possible to medically cure unruptured ectopic pregnancies of any size and avoid surgery. It could be used to treat up to 80-90% of all ectopics. If translated to clinical care, it will revolutionise management of this acute gynaecological emergency” said Dr Tong.