HDMTX Role in Cancer

Methotrexate: A Potent and Powerful Cancer Therapy1,2

Methotrexate (MTX) is an antifolate therapeutic agent that possesses potent anticancer activity against both solid tumors and leukemia.2 High-dose methotrexate (HDMTX), defined as a dose higher than 500 mg/m2, is used to treat a range of adult and childhood cancers, including1,2:

  • Diffuse large B-cell lymphoma
  • Burkitt lymphoma
  • Adult acute lymphoblastic leukemia (ALL)
  • Pediatric ALL
  • Primary CNS lymphoma
  • Osteosarcoma

HDMTX Toxicity

For patients with normal renal function, HDMTX may be safely administered with appropriate supportive care; however, despite standard support measures, HDMTX carries the risk of severe toxicity1,2:

  • As MTX is primarily cleared by renal excretion, HDMTX-induced renal dysfunction leads to delayed MTX elimination, resulting in sustained, elevated plasma MTX concentrations
  • Exposure to millimolar concentrations of MTX for minutes to hours may lead to acute renal toxicity and other serious systemic adverse reactions

Inadequate Elimination of MTX Due to Impaired Renal Function Increases the Risk of Severe Toxicities1

When renal dysfunction occurs and other toxicities are present, standard doses of leucovorin may no longer be an effective rescue intervention.3

Administer Voraxaze® to quickly lower MTX levels and avoid further systemic damage.

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