Methotrexate

• Mechanism of Action: antimetabolite that binds to dihydrofolate reductase preventing DNA synthesis in S-phase

• Common Side Effects: bone marrow suppression, gastrointestinal disturbances, mucositis, alopecia, dermatitis, nephrotoxicity, teratogenicity, interstitial pneumonitis

• Indications: "standard" palliative therapy for recurrent or metastatic disease

• Leucovorin (Tetrahydrofolic Acid): utilized as a "rescue" agent, competitively overcomes increases intracellular pools of dUMP (also used with 5-Fluorouracil)

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