Related Experiment Videos
[Methotrexate citrovorum factor therapy in advanced hypernephromas (author's transl)]
Wiener Klinische Wochenschrift
|August 1, 1980
Summary
Methotrexate-citrovorum factor (MTX-CF) therapy shows promise for advanced renal cell carcinoma, even with impaired kidney function. This chemotherapy combination demonstrated significant survival benefits in patients with partial remission or static disease.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Context:
- Advanced renal cell carcinoma (RCC) presents significant treatment challenges.
- Evaluating chemotherapy efficacy and toxicity in patients with varying renal function is crucial.
- Methotrexate (MTX) and citrovorum factor (CF) rescue therapy is a potential treatment modality.
Purpose:
- To assess the efficacy and safety of MTX-CF based chemotherapy in patients with advanced renal cell carcinoma.
- To determine the impact of renal function on MTX dosage and treatment outcomes.
- To evaluate the overall survival in patients receiving MTX-CF therapy.
Summary:
- A study involving 13 patients with advanced renal cell carcinoma investigated MTX-CF therapy.
- Two patients received MTX monotherapy, experiencing partial remissions with significant toxicity.
- Eleven patients were treated with a combination regimen including MTX/CF, vincristine, bleomycin, and an alkylating agent.
- Dosage of MTX was adjusted based on glomerular filtration rate (GFR). Patients with GFR >70 ml/min received 150-400 mg/m², while those with GFR <70 ml/min received 35-100 mg/m².
- In the group with impaired renal function (GFR <70 ml/min), 2/7 patients achieved >50% remission, 2/7 achieved <50% remission, and 2/7 had static disease. In the normal renal function group (GFR >70 ml/min), 1/4 patients achieved >50% remission.
- Median survival time was 24 months for patients in partial remission or with static disease, versus 5 months for those with progressive disease (p < 0.001).
Impact:
- MTX-CF combination therapy demonstrates potential efficacy in advanced renal cell carcinoma, warranting further investigation.
- The findings suggest that MTX-CF therapy can be considered even in patients with compromised renal function, with appropriate dose adjustments.
- This study highlights the importance of individualized dosing strategies based on renal function for optimizing chemotherapy outcomes in RCC patients.