Methotrexate content in squamous cell carcinoma of the head and neck after low‐dose methotrexate

Schifeling, David J.; George, Todd; McGuirt, Fred; Capizzi, Robert L.; Kamen, Barton A.

doi:10.1002/mpo.2950220205

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…[11] The biological reason for this apparent difference may be related to the finding that the dihydrofolate reducatase content in human squamous-cell carcinomas is low and easily saturable by even low doses of Methotrexate. [12,13] The present study has several weaknesses inherent in its retrospective design. Systematic evaluation of quality of life or pain scores was not done.…”

Section: Discussionmentioning

confidence: 92%

Palliative low dose fortnightly methotrexate in oral cancers: Experience at a rural cancer centre from India

Chakraborty

Geetha

Sujith

et al. 2014

South Asian J Cancer

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Context:Palliative fortnightly chemotherapy in oral cancers.Aims:We present our experience with a regimen employing fortnightly (once in 2 weeks) injectable methotrexate (MTX) (40 mg/m2 ) in a predominantly elderly cohort of patients with carcinoma of oral cavity and oropharynx.Settings and Design:Retrospective chart review conducted at a rural cancer center in India.Materials and Methods:All patients with oral cavity and oropharyngeal cancers started on treatment with fortnightly injectable MTX (40 mg/m2 ) between 01/01/2011 and 31/12/2011.Statistical Analysis Used:The factors analyzed included the duration of disease control, pain control, overall survival and progression free survival which were evaluated using the Kaplan Meier method.Results:A total of 60 patients with a median age of 66.5 years were analyzed. Majority of the patients had poor nutritional status, performance status or co-morbidities. MTX was given for recurrent disease in 19 patients and after initial palliative radiotherapy in 41 patients. The median number of cycles delivered was nine. Grade 3/4 toxicities were seen in 2 patients only. Disease control rate at the end of treatment was seen in 33 (55%) patients. Median overall survival was 34 weeks (interquartile range: 17-50 weeks).Conclusions:The fortnightly regimen of MTX was well-tolerated and showed a good clinical activity in this elderly cohort of patients with advanced oral cavity and oropharyngeal cancers.

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Section: Discussionmentioning

confidence: 92%

Palliative low dose fortnightly methotrexate in oral cancers: Experience at a rural cancer centre from India

Chakraborty

Geetha

Sujith

et al. 2014

South Asian J Cancer

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“…It has been reported to saturate the tumor cell dihydrofolate reductase at this dose, and further augmentation of the dose will be devoid of any benefit. 14 In the present study, metronomic therapy was used as an alternative to the standard conventional treatment approach considering the challenges of a resourceconstrained country. This constraint-adapted approach has helped us to tide over the challenges faced.…”

Section: Discussionmentioning

confidence: 99%

Role of metronomic therapy for advanced oral cancers and predictors of response: Multi‐institutional feasibility study

et al. 2021

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Background In an era of targeted therapies, patients with cancer in resource‐constraint countries continue to struggle to find affordable care. Methods The present study is a multicenter prospective single‐arm study. Patients with expected delay in surgery, unresectable or metastatic cancers, and patients not suitable for surgery or conventional chemotherapy were included. Oral methotrexate 15 mg/m2 once a week and oral celecoxib 200 mg twice daily was used for metronomic therapy. Results At 8 weeks, a clinically complete response was seen in 2.5%, partial response in 46.6%, stable disease in 39.8%, and disease progression in 11%. Size less than 4 cm, alveolobuccal subsite, and well‐differentiated histology were significantly associated with no disease progression. Conclusion Constraint‐adapted approach of using methotrexate and celecoxib is economical with good compliance, minimal toxicity, and good efficacy. It is feasible for use in diverse settings. Individualized selection of patients based on response predictors may maximize metronomic therapy's benefit.

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“…Previous studies suggested an increased capillary endothelial permeability in tumour vessels compared with vessels in healthy tissue [16][17][18][19]. Therefore we obtained, at approximately the same time, a sample of healthy connective tissue supplied by the same tumour-serving artery to compare the uptake of labelled methotrexate in tumour and in healthy tissue.…”

Section: Discussionmentioning

confidence: 99%

First‐pass uptake of methotrexate after intra‐arterial bolus injection in human head and neck cancers

Blöchl-Daum

Mader²,

Millesi³

et al. 1996

Eur J Clin Investigation

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The aim of this study was to quantify first-pass uptake of methotrexate into tumour and healthy tissue after intra-arterial (i.a.) injection in patients with head and neck cancers. Twenty-one patients were studied; during surgery, a bolus injection of 10 mg of 3H-labelled methotrexate was administered into the tumour-supplying artery. At 15-20 s after injection, and again 2-3 h later, a biopsy of the tumour and of surrounding healthy tissue was taken and radioactivity was measured. In 8 of 17 pretreated patients the biopsy specimens contained no tumour cells. In tumour-bearing patients, radioactivity in tumour was three times higher than in healthy tissue (P = 0.006). In tumour-negative patients there was no difference in activity between the two biopsy sites (P = 0.889). However, after 2-3 h the concentration of methotrexate in all surgical specimens returned to near background level and the initial difference between tumour-positive and tumour-negative samples was lost. Our results show that i.a. injection of methotrexate does not necessarily lead to high tumour cell exposure.

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Methotrexate content in squamous cell carcinoma of the head and neck after low‐dose methotrexate

Cited by 7 publications

References 7 publications

Palliative low dose fortnightly methotrexate in oral cancers: Experience at a rural cancer centre from India

Palliative low dose fortnightly methotrexate in oral cancers: Experience at a rural cancer centre from India

Role of metronomic therapy for advanced oral cancers and predictors of response: Multi‐institutional feasibility study

First‐pass uptake of methotrexate after intra‐arterial bolus injection in human head and neck cancers

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