Cancer drug effective for brain lymphoma

NEW YORK (Reuters Health) - Treatment with high-dose methotrexate, a drug used to treat a variety of cancers, leads to a complete response in a substantial proportion of patients with lymphomas of the brain and spinal cord, new research shows.

Lymphomas are cancers involving the lymphatic system, a part of the immune system that includes lymph nodes, the spleen and the bone marrow, among other body organs. Because there is lymph tissue in the brain and spinal cord, lymphomas can arise in these organs as well.

Dr. Tracy T. Batchelor, at Massachusetts General Hospital in Boston, and colleagues treated 25 patients with newly diagnosed brain/spinal cord lymphoma with a high dose of methotrexate every 2 weeks for up to 8 weeks or until a complete response was achieved.

Although AIDS and other immune system diseases increase the risk of brain lymphoma, all of the subjects in this study were HIV negative.

Patients with a complete response to methotrexate were given additional cycles of the drug.

Twelve patients (52 percent) had a complete response to methotrexate, the authors report in the journal Neurology, and five (20 percent) remained disease-free after being followed for about 7 years. The typical survival period was approximately 55 months.

Fourteen patients have died: 11 from progression of the cancer or from an unknown cause, 2 from heart disease, and 1 from complications of infection.

"High-dose methotrexate alone or in combination with other therapies is the most effective treatment available for" lymphoma of the brain and spinal cord, Batchelor's team concludes.

SOURCE: Neurology, January 29, 2008.