“…Using the sum of eight risk-factors, FIGO is designed to predict the risk of primary, single-agent chemotherapy resistance, stratifying patients into low-(score ⩽6) and high-risk groups (score ⩾7). In the United Kingdom (UK), low-risk (LR-GTN) patients are typically treated with first-line single-agent methotrexate (MTX) [1], employing a MTX-FA 8-day regimen, whilst high-risk (HR-GTN) patients receive first-line combination chemotherapy, usually with EMA/CO (etoposide, methotrexate, dactinomycin, cyclophosphamide and vincristine [1][2][3]). Despite FIGO classification, a third of patients treated for LR-GTN are resistant to first-line MTX-FA, increasing to four out of five of those scoring 5 or 6 [4,5].…”