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Related Experiment Videos

Methotrexate levels and outcome in osteosarcoma.

Shayna Zelcer1, Michael Kellick, Leonard H Wexler

  • 1Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Pediatric Blood & Cancer
|February 11, 2005
PubMed
Summary

Peak serum concentrations of methotrexate (MTX) correlate with osteosarcoma (OS) outcomes. This study found no significant association between peak MTX levels and tumor necrosis or event-free survival in OS patients.

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Area of Science:

  • Oncology
  • Pharmacology
  • Cancer Research

Background:

  • Peak serum concentrations of methotrexate (MTX) are linked to outcomes in osteosarcoma (OS).
  • Recommended MTX peak levels range from 700 to 1,000 micromol/L for optimal treatment.
  • The study aimed to correlate peak MTX levels with tumor necrosis and patient prognosis.

Purpose of the Study:

  • To investigate the relationship between peak serum methotrexate concentrations and histologic tumor necrosis in osteosarcoma patients.
  • To determine if peak MTX levels correlate with event-free survival (EFS) in osteosarcoma.
  • To assess the impact of high-dose methotrexate (HD-MTX) on treatment outcomes in osteosarcoma.

Main Methods:

  • Patients received multi-agent adjuvant chemotherapy including high-dose MTX (12 g/m2).

Related Experiment Videos

  • Peak MTX levels were measured post-infusion.
  • Histologic evaluation assessed tumor necrosis percentage at the time of resection.

    • Main Results:

    • The median peak MTX level was 1,060 micromol/L, with considerable variability.
    • No significant association was found between mean peak MTX levels and tumor necrosis (P = 0.44).
    • No significant association was observed between mean peak MTX levels and event-free survival (P = 0.24).

    Conclusions:

    • The lack of correlation suggests most patients achieve therapeutic MTX levels with the 12 g/m2 dose.
    • Significant intra-patient variability in peak MTX levels complicates pharmacokinetic adjustments.
    • Continued use of HD-MTX for all patients, rather than dose-adapted therapy, may be warranted.