HIGH-DOSE METHOTREXATE FOR ADVANCED BREAST-CANCER

  • 1 January 1979
    • journal article
    • research article
    • Vol. 63  (5) , 757-761
Abstract
High-dose infusions of methotrexate with citrovorum factor rescue were evaluated in 27 patients with advanced recurrent breast cancer who had previously been treated with various adriamycin-containing regimens. Of 27 patients, 8 achieved objective tumor regression with a median duration of response of 26 wk. Patients (19) had previously received standard doses of methotrexate, while 8 patients had had no prior exposure to methotrexate. The response rates observed in these 2 groups of patients were similar. Except for 2 drug-related deaths, toxic effects were acceptable. Myelosuppression was mild, transient, and noncumulative. Gastrointestinal toxic effects did not appear to be dose-related and were mild in most instances. CNS dysfunction with lethargy, fatigability, confusion, and disorientation was the most significant toxic effect of this high-dose methotrexate therapy and was observed in 22% of the patients. In 2 patients treatment with this program was discontinued because of the development of renal dysfunction. High-dose methotrexate with citrovorum factor rescue appears to be an effective regimen in patients with advanced refractory breast cancer. However, in view of the enormous cost necessitated by this treatment approach, we do not feel further studies would be worthwhile.

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