methotrexate

P1, N=24, Recruiting, City of Hope Medical Center | Trial completion date: Feb 2026 --> May 2026 | Trial primary completion date: Feb 2026 --> May 2026

P2, N=53, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Jun 2026 --> Jan 2027

IT MTX should not be considered in traumatic SCI. Future studies should define safe systemic dosing windows in injured spinal cord models and evaluate cautious early-phase clinical trials under strict monitoring.

P2, N=97, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Jan 2026 --> Jan 2027

P1, N=48, Not yet recruiting, Otsuka Pharmaceutical Development & Commercialization, Inc.

P=N/A, N=330, Not yet recruiting, PETHEMA Foundation

Serum MTX concentration serves as an objective marker of MTX-related toxicity. Under adequate rescue therapy and concentration monitoring, a single MTHFR polymorphism appears insufficient to guide dose adjustment. A combined strategy is recommended, with concentration monitoring as the primary approach and genetic factors as an adjunct.

The combination of multivitamins (Centrum) has a more significant improvement than one vitamin (Vitamin E) on the low-dose methotrexate testicular injury.

This review synthesizes current evidence on key pharmacogenetic variants influencing the response to major classes of antineoplastic agents used in children, including thiopurines, methotrexate, anthracyclines, alkylating agents, vinca alkaloids, and platinum compounds...Furthermore, it highlights how integrative multi-omics, systems pharmacology, and artificial intelligence may accelerate the translation of pharmacogenomic data into clinical decision-making. The integration of pharmacogenomic testing into pediatric oncology protocols has the potential to transform cancer care by improving drug safety, enhancing treatment precision, and paving the way toward ethically grounded, personalized therapy for children.

Background: Colorectal and pancreatic cancers remain therapeutically challenging, with limitations in efficacy and limitations due to toxicity from conventional antimetabolites such as 5-fluorouracil (5-FU), methotrexate (MTX), and gemcitabine (GEM). Lactam steroidal antimetabolite hybrids, particularly CS23, act as dual TS/DHFR inhibitors, inducing apoptosis and cell cycle arrest with improved selectivity. Their strong in silico-in vitro concordance provides a compelling preclinical rationale for further evaluation of steroidal antimetabolites as next-generation therapeutics for resistant gastrointestinal malignancies.

Methotrexate was the most common prior systemic therapy (87.8%), with no difference between the groups (p = 0.7668)... Biological therapies were associated with significant improvements in disease severity and quality of life. Anti-TNF therapies were switched more frequently due to reduced efficacy, while clinical improvement was observed regardless of lesion localization.

Flumatinib likewise lowered MTX clearance and raised ≥ grade 2 nephrotoxicity to 29.4%, yet neither effect reached statistical significance. Temporary withdrawal of olverembatinib before HD-MTX infusion may prevent MTX-related nephrotoxicity.