AUTHOR(S): 

Tesfaye H., Jedlickova B., Prusa R., Korandova A., Linke Z., Becvarova M., Shimota M.

TITLE

Significantly Delayed Elimination of Methotrexate in Osteosarcoma Patient: An Association with Impaired Renal Function Deterioration

KEYWORDS

Osteosarcoma, methotrexate-induced nephrotoxicity, rescue therapy, leucovorin, carboxypeptidase-G2

ABSTRACT

Methotrexate is one of widely used anti-cancer agent. High-dose methotrexate (HDMTX) followed by leucovorin rescue therapy is an important component in the treatment of a variety of cancers including osteosarcoma. Unfortunately, acute renal failure and other adverse effects are hardly avoidable. Despite advanced care measures, HDMTX-induced renal dysfunction continues to occur in approximately 2% of patients with osteosarcoma. The aim of this contribution is to describe the case of an adult Caucasian male patient with osteosercoma, who demonstrated extremely delayed MTX elimination after HDMTX treatment according to the European and American Osteosarcoma Study Group (EURAMOS) joint protocol using an initial dose of 12 g/m2 over a 4-hour infusion. We also discuss the fate of the patient where delayed MTX excretion was a great challenge and how promptly recognition of patients with poor MXT elimination is of vital importance to start effective rescue therapy for better overall outcomes.

Cite this paper

Tesfaye H., Jedlickova B., Prusa R., Korandova A., Linke Z., Becvarova M., Shimota M.. (2016) Significantly Delayed Elimination of Methotrexate in Osteosarcoma Patient: An Association with Impaired Renal Function Deterioration. International Journal of Oncology and Cancer Therapy, 1, 1-6