High-dose methotrexate in osteosarcoma--Mayo Clinic studies

While high-dose methotrexate (HDMTX) is active against some osteosarcomas, its efficacy as a single agent in the treatment of metastatic disease has not been uniformly demonstrated. Furthermore, the results of a limited randomized study comparing HDMTX-vincristine with observation alone as primary adjuvant treatment do not support the thesis that HDMTX has been an essential factor in the recently improved control of primary osteosarcoma. Despite this uncertainty concerning the specific contribution of methotrexate to these results, multidrug regimens containing this agent do appear to improve the prognosis of patients with primary osteosarcoma. Regimens which exclude HDMTX reasonably may be studied in the adjuvant treatment of primary osteosarcoma.