Methotrexate Treatment for Advanced Bladder Cancer

Summary Intermittent intravenous methotrexate has been used to treat patients with locally advanced or metastatic transitional cell carcinoma of the bladder (40 cases) and of the renal pelvis (2 cases). Objective evidence of tumour regression, attributable to the methotrexate therapy, was observed in 11 patients (26 %) for 2 to 20 months. Several other patients gained relief of symptoms but in these there was no clear evidence of tumour regression. Toxic side‐effects from methotrexate interrupted treatment for a time in 29 patients but were seldom serious and were never fatal. It is concluded that intravenous methotrexate therapy is of value in the management of advanced bladder cancer. The possibility of improving tumour response and decreasing drug toxicity is discussed.