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[Clinical experiences with high-dose methotrexate].

K Geissler, R Lenzhofer, B Schneeweiss

    Wiener Klinische Wochenschrift
    |May 11, 1984
    PubMed
    Summary
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    High-dose methotrexate (MTX) therapy showed limited efficacy in advanced cancers, with only three objective remissions observed. Complications were noted, and this high-dose MTX approach is not recommended after conventional treatments.

    Area of Science:

    • Oncology
    • Pharmacology

    Background:

    • Conventional chemotherapy regimens were previously administered to 40 patients with advanced malignant diseases.
    • High-dose methotrexate (MTX) was investigated as a sole therapeutic agent for these patients.

    Purpose of the Study:

    • To evaluate the efficacy and toxicity of high-dose methotrexate (MTX) in patients with advanced malignant diseases who had exhausted conventional treatment options.

    Main Methods:

    • Patients received varying doses of MTX: moderately high (250–750 mg/m2), high (5–15 g), and ultra-high doses.
    • Treatment intervals were generally 10 days, with some variations for specific cases.

    Main Results:

    • Objective remission was observed in three patients treated with high-dose MTX; none in moderately high-dose, lymphoma, or ultra-high-dose groups.

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  • Complications included leucopenia/thrombopenia (9%), reversible transaminase increases (45%), and decreased creatinine clearance (10%).
  • Severe toxic epidermiolysis and respiratory distress syndrome were reported in two patients.

    • Conclusions:

    • High-dose MTX therapy demonstrated limited efficacy as a salvage treatment for advanced cancers.
    • The observed toxicity profile and lack of significant benefit do not support its use after conventional therapies fail.