Mitomycin Fluorouracil

Christie DR, Bull C A, Gebski V, etal. Concurrent 5-fluorouracil, mitomycin C and irradiation in locally advanced cervix cancer. Radiother Oncol 1995 37 181-189. 

Evans LS, Kersh CR, Constable WC, et al. Concomitant 5-fluorouracil, mitomycin-C, and radiotherapy for advanced gynecologic malignancies. Int J Radiat Oncol Biol Phys 1988 15 901-906. 

The elevated expression of calpastatin, a specific inhibitor of calpain, induced in human UV -1 fibroblasts by transfection of its cDNA resulted in decreased survival in the presence of okadaic acid but in no apparent alteration in the sensitivity to other drugs such as 5-fluorouracil, mitomycin C and me-tothrexate (Cm et al. 1999). 

The clinical observation that the simultaneous combination of 5-fluorouracil, mitomycin C, or cis-platin with radiation is of value in rapidly proliferating squamous cell cancers has led to the assumption that the addition of drugs may influence the potential of cancer cells to repopulate. At least for mitomycin C this effect was documented precisely using a xenograft model (Budach et al. 2002). In this model, transplanted tumors were treated with 11 x 4.5 Gy fractionated radiation under ambient conditions with or without mitomycin C followed by a graded top-up dose on days 16, 23,30, or 37 given under hypoxic conditions. Repopula-... 

Insulinoma Streptozocin, interferon Doxorubicin, fluorouracil, mitomycin, streptozocin... 

Chemotherapeutic agents that have significant cancer response when combined with hyperthermia (up to 43°C) include doxorubicin, melphalan, mitomycin C (MMC), mitoxantrone, gemcitabine, etoposide, and especially the platinum-based agents carboplatin and oxaliplatin (Mohamed et al., 2003 Sugarbaker et al., 2005). Agents that do not work well with hyperthermia include irinotecan, paclitaxel, docetaxel, 5-fluorouracil, and floxuridine (Mohamed et al., 2003 Sugarbaker et al., 2005). 

Cummings B J, Keane TJ, O Sullivan B, et al. Epidermoid anal cancer treatment by radiation alone or by radiation and 5-fluorouracil with and without mitomycin C. Int J Rad One Biol Phys 1991 21(5) 115-125. 

Flam M, John M, Pajak TF, et al. Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoidcarcinoma of the anal canal results of a phase III randomized intergroup study. J Clin Oncol 1996 14 2527-2539. 

UKCCCR Epidermoid anal cancer results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Coordinating Committee on Cancer Research. Lancet 1996 348 1049-1054. 

Flam MS, John JM, Pajak T, et al. Radiation (RT) and 5-fluorouracil (5-FU) vs radiation, 5-FU, mitomycin-C (MMC) in the treatment of anal carcinoma results of a phase III randomized RTOG/ ECOG intergroup trial. Proc Annu Meet Am Soc Clin Oncol 1995 14 191. Abstract A443. 

Keane TJ, Cummings B J, O Sullivan B, et al. A randomized trial of radiation therapy compared to split course radiation therapy combined with mitomycin C and 5 fluorouracil as initial treatment for advanced laryngeal and hypopharyngeal squamous carcinoma. Int J Radiat Oncol Biol Phys 1993 25 613-618. 

B = bleomycin, C = chlorambucil, CT = chemotherapy, DFS = disease-free survival, Ep = epirubicin, F = fluorouracil, I = ifosfamide, M = mitomycin C, Mtx = methotrexate, O = vincristine, OS = overall survival, P = cisplatin, RT = radiation therapy, V = vinblastine. 

North American prospective trials of radiation sensitizers for cervical cancer have focused on the use of cisplatin, fluorouracil, and hydroxyurea. However, a number of other drugs also hold promise as effective radiation sensitizers for cervical cancer, including mitomycin C, epirubicin, paclitaxel, and carboplatin. 

Citing the success of mitomycin-C in the treatment of anal cancer, a number of investigators have explored the use of this drug, usually in combination with fluorouracil, in patients treated with radiation for cervical and vulvar carcinomas (23-27). Roberts et al. (27) recently reported results of an interim analysis of a randomized trial, conducted in Venezuela, in which women with locally advanced cervical cancer were treated with radiation therapy with or without mitomycin. At the time of this interim analysis (published while the authors were continuing to accrue patients to the study), the authors noted a significant improvement in disease-free survival (p - 0.01) with chemotherapy but no significant difference in overall survival (p = 0.1). 

Trials of cisplatin-based chemoradiation have not yet demonstrated any dramatic increase in the incidence of major late complications with the addition of concurrent cisplatin. However, most of these trials did not have sufficiently mature follow-up at the time of publication to permit full evaluation of the comparative risks. Thomas et al. (35) reported a significantly higher rate of serious late bowel complications in patients who received mitomycin with or without fluorouracil than in patients who received fluorouracil alone (p = 0.004). However, Roberts etal. (27) have not yet reported an increased rate of late complications with chemotherapy in their Venezuelan study of radiation alone vs radiation plus mitomycin C and fluorouracil. Long-term follow-up of the randomized trials will be needed to improve our understanding of the influence of concurrent chemotherapy on late complications. 

In general, phase II trials of chemoradiation for vulvar cancer have yielded encouraging response rates (Table 4). Most studies of cisplatin or mitomycin C plus fluorouracil have yielded vulvar local control rates of better than 50% in women with advanced... 

FU = fluorouracil, CDDP = cisplatin, Mito = mitomycin-C, RT = radiation therapy. 

Landoni F, Maneo A, Zanetta G, et al. Concurrent preoperative chemotherapy with 5-fluorouracil and mitomycin C and radiotherapy (FUMIR) followed by limited surgery in locally advanced and recurrent vulvar carcinoma. Gynecol Oncol 1996 61 321-327. 

Fujimoto, S., Miyazaki, M., et al. Biodegradable mitomycin C microspheres given intraarterially for inoperable hepatic cancer With particular reference to a comparison with continuous infusion of mitomycin C and 5-fluorouracil. Cancer. 56(10) 2404-2410. 

Gastric adenocarcinoma Fluorouracil, doxorubicin (Adriamycin), and mitomycin (FAM), or fluorouracil and semustine. 

Common causative organisms in adults with canaliculitis include Staphylococcus aureus and Actinomyces species. Primary herpetic infections (herpes simplex, varicella, and vaccinia) have a higher prevalence among patients younger than age 20 years and often present with cutaneous manifestations of the infectious disease. Chronic allergies may also be associated with canalicular obstruction. Occasionally, patients may suffer from canalicular obstruction as a result of topical antimetabolite treatment such as 5-fluorouracil or mitomycin C. 

A 55-year-old man with gastric adenocarcinoma received fluorouracil 1 g intravenously each week for 9 weeks and mitomycin 10 mg intravenously every 3 weeks (46). After 12 treatments he developed severe dyspnea. 

Although mitomycin C was most likely the agent responsible for pulmonary toxicity in this patient, combined use with fluorouracil as a contributing factor cannot be ruled out. Necropsy confirmed that the patient had interstitial... 

Fielding JW, Stockley RA, Brookes VS. Interstitial lung disease in a patient treated with 5-fluorouracil and mitomycin C. BMJ 1978 2(6137) 602. 

Colozza M, Tonato M, Grignani F, Davis S. Low-dose mitomycin and weekly low-dose doxorubicin combination chemotherapy for patients with metastatic breast carcinoma previously treated with cyclophosphamide, methotrexate, and 5-fluorouracil. Cancer 1988 62(2) 262-5. 

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