Methotrexate: an active drug in bladder cancer.
Forty-nine patients with transitional urothelial tract tumors received methotrexate: 0.5-1.0 mg/kg I.V. Q W (40 patients) or 250 mg/M2 in a 2-hour infusion with citrovorum factor rescue 24 hours later (nine patients). Eleven (26%, 95% confidence limits 13-39%) of 42 patients with bidimensionally measurable metastases achieved partial remission. Most responses occurred within 2-3 weeks and persisted for a median duration of six months (range, 2-20). Response rates were increased to 38% (6/16 patients, 95% confidence limits 18-65%) in patients who had no prior chemotherapy, and a 90-100% performance status (50, 5/10 patients, 95% confidence limits 22-78%) compared with 19% (5/26, 95% confidence limits 8-37%) in patients who had prior chemotherapy and a less than or equal to 80% performance status (19%, 6/32 cases, 95% confidence limits 9-32%). Toxicity included mucositis and myelosuppression. A review of the literature coupled with the present data suggest that methotrexate is as active as cisplatin in the treatment of patients with advanced urinary bladder cancer.
D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011379:Prognosis; D014516:Ureteral Neoplasms / Q000188:drug therapy; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D002955:Leucovorin; D008727:Methotrexate