Methotrexate for relapse of metastatic non-seminomatous germ-cell tumours

Twelve patients with metastatic non-seminomatous germ-cell tumours who relapsed after 3-9 courses (median 7) of cis-platin containing combination chemotherapy, were treated with moderately high-dose methotrexate (1 g m-2) and folinic acid rescue. There was one partial response and the remaining eleven patients showed progression of disease. The patient that responded was one of two patients treated at the time of first relapse. It is concluded that methotrexate does not have a useful role in the salvage treatment of germ-cell tumours relapsing after cis-platin-containing chemotherapy or in patients who are primarily resistant to cis-platin-containing regimes.