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OncoMatch/Clinical Trials/NCT02422641

Prospective Evaluation Of High-Dose Systemic Methotrexate In Patients With Breast Cancer And Leptomeningeal Metastasis

Is NCT02422641 recruiting? Yes, currently enrolling (May 2026). This Phase 2 trial studies High-dose Methotrexate (8 gm/m2; HD-MTX) for metastatic breast cancer.

Phase 2RecruitingWake Forest University Health SciencesNCT02422641Data as of May 2026

Treatment: High-dose Methotrexate (8 gm/m2; HD-MTX)This study is a prospective evaluation of systemic, intravenous high-dose methotrexate (HD-MTX, 8 g/m2) in patients with triple negative, HER2-positive, and hormone refractory breast cancer with leptomeningeal metastasis (LMD) with or without brain parenchymal involvement.

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Extracted eligibility criteria

Cancer type

Breast Carcinoma

Biomarker criteria

Required: ESR1 negative (ER-negative)

TRIPLE NEGATIVE (ER-negative, PR-negative, and HER2-negative disease)

Required: PR (PGR) negative (PR-negative)

TRIPLE NEGATIVE (ER-negative, PR-negative, and HER2-negative disease)

Required: HER2 (ERBB2) negative (HER2-negative)

TRIPLE NEGATIVE (ER-negative, PR-negative, and HER2-negative disease)

Required: HER2 (ERBB2) overexpression (HER2-positive)

HER2-POSITIVE: HER2-positive patients will be defined per ASCO-CAP Guidelines.

Allowed: ESR1 positive

HORMONE REFRACTORY: Patients with ER/PR-positive disease... may be considered if they have disease progression after two lines of hormonal therapy... or are deemed clinically hormone-resistant...

Allowed: PR (PGR) positive

HORMONE REFRACTORY: Patients with ER/PR-positive disease... may be considered if they have disease progression after two lines of hormonal therapy... or are deemed clinically hormone-resistant...

Disease stage

Metastatic disease required

Performance status

ECOG 0–1(Restricted strenuous activity)

Prior therapy

Must have received: hormonal therapy — adjuvant or metastatic

disease progression after two lines of hormonal therapy (administered in the adjuvant or metastatic setting), or are deemed clinically hormone-resistant

Cannot have received: methotrexate containing systemic regimen (methotrexate)

Exception: excluding intrathecal methotrexate

Prior treatment with any methotrexate containing systemic regimen within 1 year (excluding intrathecal methotrexate)

Cannot have received: chemotherapy

Chemotherapy... within the last 2 weeks

Cannot have received: stereotactic radiotherapy

stereotactic radiotherapy within the last 2 weeks

Cannot have received: whole brain radiotherapy

Whole brain radiotherapy within the last 6 months

Cannot have received: partial brain radiotherapy

Exception: partial brain radiotherapy <40% of total brain volume within the last 2 weeks; partial brain radiotherapy >40% of total brain volume within the last 6 months

Partial brain radiotherapy (i.e. <40% of total brain volume) within the last 2 weeks; partial brain radiotherapy exceeding >40% of total brain volume within the last 6 months

Lab requirements

Blood counts

White blood cell counts >3000 cells/mcL; Absolute neutrophil count >1500 cells/mcL; Platelet count >100,000 cells/mcL; Hematocrit >30%

Kidney function

Estimated creatinine clearance >70 cc/min (Cockcroft-Gault formula)

Liver function

Serum bilirubin <1.5 x the ULN or <5x the ULN if secondary to liver metastasis; ALT or AST <2.5x the ULN or <5x the ULN if secondary to liver metastasis; Alkaline phosphatase <2.5x the ULN or <5x the ULN if secondary to liver metastasis

Adequate organ function as follows: Estimated creatinine clearance >70 cc/min (calculated by Cockcroft-Gault formula) White blood cell counts >3000 cells/mcL Absolute neutrophil count >1500 cells/mcL Platelet count >100,000 cells/mcL Hematocrit >30% Serum bilirubin <1.5 x the ULN or <5x the ULN if secondary to liver metastasis Alanine aminotransferase or aspartate aminotransferase <2.5x the ULN or <5x the ULN if secondary to liver metastasis Alkaline phosphatase <2.5x the ULN or <5x the ULN if secondary to liver metastasis

Structured fields extracted by AI. May contain errors — verify against the official protocol.

US trial sites

  • Sidney Kimmel Comprehensive Cancer Center · Baltimore, Maryland
  • Siteman Cancer Center- Washington University School of Medicine in St. Louis · St Louis, Missouri
  • Comprehensive Cancer Center at Wake Forest University (CCCWFU) · Winston-Salem, North Carolina

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