Should high-dose methotrexate be used in the treatment of AYA patients with osteosarcoma?

It has been our practice to use high dose methotrexate (HDMTX) in the treatment of our AYA osteosarcoma patients. Methotrexate has been an important component of most osteosarcoma treatment protocols for many years and is generally considered part of the standard of care for this disease (Grem et al...

Agree with the efficacy and toxicity ratio in favor of MTX with careful supportive care. The MTX dosing calculator in development by Dr. Laura Ramsey at Cincinnati may be of help in these patients.