Methotrexate diffusion from acrylic cement. Local chemotherapy for bone tumours

Area of Science:

• Oncology
• Biomaterials Science
• Pharmacology

Background:

• Malignant bone lesions pose significant treatment challenges.
• Conventional chemotherapy has limitations in targeting localized bone tumors.
• Acrylic cement offers a potential drug delivery vehicle for localized chemotherapy.

Purpose of the Study:

• To investigate the efficacy of acrylic cement loaded with methotrexate (MTX) for treating malignant bone lesions.
• To evaluate the in vitro drug release kinetics of MTX from acrylic cement.
• To assess the in vivo therapeutic effects and safety of MTX-loaded cement in animal models and preliminary human studies.

Main Methods:

• In vitro studies assessed MTX diffusion from methylpolymethacrylate cement after polymerization.
• In vivo studies involved induced osteosarcoma in rats and spontaneous osteosarcoma in dogs treated with MTX-loaded cement.
• Preliminary studies were conducted on human patients with malignant bone tumors.

Main Results:

• Methotrexate (MTX) was stable during cement polymerization and released over six months.
• In rats, MTX-loaded cement demonstrated dose-dependent local and systemic anti-tumor effects.
• In dogs, treatment increased survival, reduced local recurrence, and showed detectable systemic effects, with some cases of delayed wound healing.

Conclusions:

• Acrylic cement is a viable carrier for localized methotrexate delivery in bone tumors.
• This localized chemotherapy approach shows potential for improving outcomes in malignant bone tumors.
• Further investigation in human patients is warranted to confirm its therapeutic utility.