Although high-dose methotrexate is widely accepted as the most effective chemotherapeutic agent for primary CNS lymphoma, no optimal dose or dosing strategy has been established. Researchers from the International Extranodal Lymphoma Study Group used clinical trial data to explore whether or not an area under the curve model might be useful to optimize methotrexate dosing. The results strongly suggest that effective methotrexate dose is an important variable in patient outcome.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
A minimal physiologically based pharmacokinetic model for high-dose methotrexate
Cancer Chemotherapy and Pharmacology Open Access 13 June 2021
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Morris, P. G. & Abrey, L. E. Therapeutic challenges in primary CNS lymphoma. Lancet Neurol. 8, 581–592 (2009).
Ferreri, A. J. et al. Area under the curve of methotrexate and creatinine clearance are outcome-determining factors in primary CNS lymphomas. Br. J. Cancer 90, 353–358 (2004).
Joerger, M. et al. Methotrexate area under the curve is an important outcome predictor in patients with primary CNS lymphoma: a pharmacokinetic-pharmacodynamic analysis from the IELSG no. 20 trial. Br. J. Cancer 102, 673–677 (2010).
Ferreri, A. J. et al. High-dose cytarabine plus high-dose methotrexate versus high-dose methotrexate alone in patients with primary CNS lymphoma: a randomised phase 2 trial. Lancet 374, 1512–1520 (2009).
Zelcer, S. et al. Methotrexate levels and outcome in osteosarcoma. Pediatr. Blood Cancer 44, 638–642 (2005).
Vassal, G. et al. Cerebrospinal fluid and plasma methotrexate levels following high-dose regimen given as a 3-hour intravenous infusion in children with nonHodgkin's lymphoma. Pediatr. Hematol. Oncol. 7, 71–77 (1990).
Hiraga, S. et al. Rapid infusion of high-dose methotrexate resulting in enhanced penetration into cerebrospinal fluid and intensified tumor response in primary central nervous system lymphomas. J. Neurosurg. 91, 221–230 (1999).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
L. E. Abrey receives grant/research support from Genentech and Novartis. She is also a consultant for Novartis and is on the speakers bureau for Schering-Plough.
Rights and permissions
About this article
Cite this article
Abrey, L. Individualized methotrexate dosing in primary CNS lymphoma. Nat Rev Clin Oncol 7, 306–307 (2010). https://doi.org/10.1038/nrclinonc.2010.66
Issue Date:
DOI: https://doi.org/10.1038/nrclinonc.2010.66
This article is cited by
-
A minimal physiologically based pharmacokinetic model for high-dose methotrexate
Cancer Chemotherapy and Pharmacology (2021)
