Increased levels of methotrexate would not produce toxic effects in mesothelioma patients; Research

Methotrexate injection into the lungs

Researchers in the phase-I pilot study has found that infusion of drug in the pleural space around the lungs in the patients of mesothelioma cause no grade-II toxicities.

This research has been done by Egyptian researchers and has been published online in the July 9th issue of the American Journal of Clinical Oncology.

Methotrexate (MTX) is one of the oldest chemotherapeutic agents normally used to treat rheumatoid arthritis, psoriasis, and certain cancers including lung, breast, uterine and some blood cancers.

Researchers, in this study, were working on the increasing dose of MTX infused intrapleural over 5 days period. They worked on 5 patients, who were infused 3 cycles of MTX into the pleural cavity. With each treatment, the dose was increased and the researchers checked the MTX in the pleural fluid and the blood serum daily. They found no level of grade-II toxicities.

Researchers concluded in the study,

This study demonstrates no grade II toxicity from 750.5 mg/m of MTX infused intrapleural over 5 days. This approach allows attaining MTX pleural levels that are 95 to 3000 times higher than systemic serum levels, with minimal toxicity. The results mandate performing this trial on a wider scale as a preliminary step for a formal phase II study.


Ellithy, Mahmoud Mahmoud Abbass MD, PhD; El Baghdady, Noha Salah El Din M. BSc; El Wakeel, Lamia Mohamed MD, PhD; Abdeltawab, Karim Ahmed MSc; Badary, Osama Ahmed PhD, (2012). An Open-label Phase I Pilot Study of Continuous Intrapleural Infusion of Escalated Doses of Methotrexate in Malignant Pleural Mesothelioma. American Journal of Clinical Oncology, doi: 10.1097/COC.0b013e318256f5ba

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