methotrexate + temozolomide

Methotrexate plus temozolomide (MT regimen) is a chemotherapy combination used primarily for treating primary central nervous system lymphoma (PCNSL). This regimen combines high-dose methotrexate, which inhibits folate metabolism and nucleotide synthesis, with temozolomide, an oral alkylating agent that penetrates the blood-brain barrier and causes DNA damage through methylation. The MT regimen is often used as first-line treatment for PCNSL, particularly in patients who cannot receive other therapies. In clinical studies, this combination has shown objective response rates of approximately 69% when used alone[1]. The efficacy can be further enhanced by adding rituximab (creating the RMT regimen), which increases the objective response rate to about 93.7%[1]. High-dose methotrexate (typically 3-8 g/m²) forms the backbone of this therapy, with temozolomide (usually 100-200 mg/m² for 5 days per cycle) added to enhance anti-tumor activity[2]. This combination is particularly valuable for elderly patients with PCNSL, as it offers a favorable toxicity profile compared to more intensive regimens[2].

Other names

MT regimen