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

Chakraborty, Santam; Geetha, M.; Sujith, KM; Biji, M S; Sateeshan, B.

doi:10.4103/2278-330x.136798

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…The first‐line treatment of both very large and unresectable OSCC and ESCC involves the use of drugs, such as cisplatin (Cis, 1 ; Figure ), carboplatin ( 2 ), 5‐fluorouracil (5‐FU, 3 ), methotrexate (MTX, 4 ), and taxanes (paclitaxel, 5 and docetaxel, 6 ) . Such therapies, however, did not show any significant increase in the level of overall survival (OS) over the past two decades.…”

Section: Introductionmentioning

confidence: 99%

Autophagy modulators for the treatment of oral and esophageal squamous cell carcinomas

Khan

Relitti

Brindisi

et al. 2019

Medicinal Research Reviews

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Oral squamous cell carcinomas (OSCC) and esophageal squamous cell carcinomas (ESCC) exhibit a survival rate of less than 60% and 40%, respectively. Late-stage diagnosis and lack of effective treatment strategies make both OSCC and ESCC a significant health burden. Autophagy, a lysosome-dependent catabolic process, involves the degradation of intracellular components to maintain cell homeostasis. Targeting autophagy has been highlighted as a feasible therapeutic strategy with clinical utility in cancer treatment, although its associated regulatory mechanisms remain elusive. The detection of relevant biomarkers in biological fluids has been anticipated to facilitate early diagnosis and/or prognosis for these tumors. In this context, recent studies have indicated the presence of specific proteins and small RNAs, detectable in circulating plasma and serum, as biomarkers. Interestingly, the interplay between biomarkers (eg, exosomal microRNAs) and autophagic processes could be exploited in the quest for targeted and more effective therapies for OSCC and ESCC. In this review, we give an overview of the available biomarkers and innovative targeted therapeutic strategies, including the application of autophagy modulators in OSCC and ESCC.Additionally, we provide a viewpoint on the state of the art Tuhina Khan and Nicola Relitti contributed equally to this work. and on future therapeutic perspectives combining the early detection of relevant biomarkers with drug discovery for the treatment of OSCC and ESCC. K E Y W O R D S autophagy, autophagy modulators, biomarkers, esophageal squamous cell carcinoma, exosomes, oral squamous cell carcinoma, targeted therapy 1 | INTRODUCTION Oral squamous cell carcinoma (OSCC) is the predominant malignant neoplasm of the oral cavity followed by verrucous carcinoma, undifferentiated carcinoma, and small salivary adenocarcinoma. 1 Esophageal squamous cell carcinoma (ESCC) is the first histological type and accounts for 80% of cases of esophageal cancer. 2 OSCC and ESCC are indicated as one of the most common cancers by the International Union Against Cancer with an annual incidence of 275 000 and 456 000 cases worldwide, respectively. 3,4 The primary etiology in both OSCC and ESCC is attributed to the environmental factors (tobacco abuse, alcohol consumption), genetic factors (eg, mutations in enzymes), viral factors (human papilloma virus [HPV] infection), and/or the coexistence of these factors. Alcohol intake and tobacco use are responsible for at least 75% of these carcinomas. The underlying initiation and progression mechanisms of OSCC and ESCC are generally characterized by the accumulation of serial epigenetic and genetic alterations, which eventually lead to uncontrolled proliferation of the mutated cells, followed by vigorous cell division. 5,7 Early-stage OSCC detection displays an 80% survival rate at 5 years, while detection at advanced stage leads to survival rates ranging from 20% to 40%. 6 In ESCC, the 5-year survival rate for early-stage detection may reach 85%, whereas a dr...

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Section: Introductionmentioning

confidence: 99%

Autophagy modulators for the treatment of oral and esophageal squamous cell carcinomas

Khan

Relitti

Brindisi

et al. 2019

Medicinal Research Reviews

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“…Chakraborty et al . reported “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.”[ 1 ] In fact, the effectiveness of palliative low dose fortnightly MTX has been mentioned in other cancers like prostate cancer. [ 2 ] Nevertheless, the side effect of using MTX has to be mentioned and well-evaluated.…”

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“…[ 3 ] The good early sign is “cutaneous erosion,” which is not mentioned in the report by Chakraborty et al . [ 1 ] Finally, the use of additional supplementation to reduce the toxicity of metrotrexate like folic acid should be discussed. [ 4 ]…”

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confidence: 99%

Palliative low dose fortnightly methotrexate in oral cancer

Tin¹,

Wiwanitkit

2015

South Asian J Cancer

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“…We would like to commend Chakraborty et al . [ 1 ] for reigniting interest in the use of methotrexate in palliative care in head and neck carcinomas. Palliation in head and neck region poses many problems; most of the patients are elderly with a multitude of comorbidities.…”

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Methotrexate, an attractive agent for palliation in head and neck cancers

Sharma

Gupta

Fotedar

et al. 2014

South Asian J Cancer

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Letters to Editor infirm patients the relatively painful intravenous route. Thus, it would also be a much cheaper alternative to gefitinib. The point of concern is that common medications need to be monitored during methotrexate therapy. Pain is a common complaint in advanced head and neck malignancy, and non-steroidal anti-inflammatory drug are commonly prescribed to such patients. Many fatal interactions have been described on concomitant use. [4] Many other common drugs like folic acid, proton pump inhibitors, etc., have effects on either the toxicity or the effectiveness of this drug. [5] Thus, due caution in use with methotrexate is needed. To conclude, the options like methotrexate need to be explored further. Low-income groups would definitely benefit with such approaches.

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

Cited by 8 publications

References 14 publications

Autophagy modulators for the treatment of oral and esophageal squamous cell carcinomas

Autophagy modulators for the treatment of oral and esophageal squamous cell carcinomas

Palliative low dose fortnightly methotrexate in oral cancer

Methotrexate, an attractive agent for palliation in head and neck cancers

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