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Summary
Methotrexate shows significant efficacy in treating advanced urothelial tract tumors, achieving partial remission in 26% of patients. Higher response rates were observed in those without prior chemotherapy and with better performance status.
Area of Science:
- Oncology
- Urothelial Carcinomas
- Chemotherapy
Background:
- Transitional urothelial tract tumors are a significant cause of cancer morbidity.
- Advanced stages often require systemic chemotherapy for effective management.
Purpose of the Study:
- To evaluate the efficacy and toxicity of methotrexate in patients with advanced transitional urothelial tract tumors.
- To compare methotrexate's activity with cisplatin based on literature review and current data.
Main Methods:
- Forty-nine patients with advanced urothelial tract tumors received methotrexate via intravenous infusion at two different dosages.
- Response rates were assessed in patients with measurable metastases, stratified by prior chemotherapy and performance status.
- Toxicity profiles, including mucositis and myelosuppression, were recorded.
Main Results:
- Partial remission was achieved in 26% of patients with measurable metastases.
- Patients with no prior chemotherapy and higher performance status (90-100%) showed increased response rates (38%) compared to those with prior chemotherapy and lower performance status (19%).
- Median response duration was six months, with toxicities including mucositis and myelosuppression.
Conclusions:
- Methotrexate demonstrates significant activity in advanced urothelial tract tumors.
- The drug appears to be as effective as cisplatin for advanced bladder cancer treatment.
- Patient characteristics, such as prior chemotherapy and performance status, influence treatment response.