Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Methotrexate escalation in T-cell ALL

Winter SS et al. J Clin Oncol. 2018 Aug 23. doi: 10.1200/JCO.2018.77.7250.

Key clinical point: An escalating methotrexate strategy improved survival, compared with high-dose methotrexate, in T-cell acute lymphoblastic leukemia (T-ALL).

Major finding: The 5-year disease-free survival rate was 91.5% versus 85.3% (P = .005) and overall survival was 93.7% versus 89.4% (P = .036), respectively, for the escalating and high-dose approaches.

Study details: Results after methotrexate randomization in 1,031 T-ALL patients without CNS3 disease or testicular leukemia in the Children’s Oncology Group (COG) AALL0434 trial.

Disclosures: The study was supported by grants from the National Institutes of Health and by St. Baldrick’s Foundation. The authors reported disclosures related to Amgen, Jazz Pharmaceuticals, Novo Nordisk, Tandem, Pfizer, Novartis, and TypeZero Technologies, among others.

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Winter SS et al. J Clin Oncol. 2018 Aug 23. doi : 10.1200/JCO.2018.77.7250.

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