title: A phase II study of mitomycin C, cisplatin and continuous infusion 5-fluorouracil (MCF) in the treatment of patients with carcinoma of unknown primary site.
abstract: Carcinoma of unknown primary site remains a common clinical diagnosis, accounting for between 5 and 10% of all cancer patients. Numerous combination chemotherapy regimens have been used in the management of carcinoma of unknown primary site, resulting in response rates of 0-48%. We present the results of a single centre phase II study of the use of the combination of mitomycin C (7 mg m(-2) on day 1 of cycles 1, 3 and 5) cisplatin (60 mg m(-2) on day 1) and continuous infusion 5-fluorouracil (300 mg m(-2) daily), MCF, delivered as a 21-day cycle, in patients with carcinoma of unknown primary site. Thirty-one patients with a diagnosis of carcinoma of unknown primary site were treated in Aberdeen Royal Infirmary between 1997 and 2001 with MCF. In total, 136 cycles of MCF were delivered (median of 5 cycles per patient). Toxicity was acceptable, with 19% grade 3 or 4 neutropenia, 16% grade 3 or 4 thrombocytopenia and 13% grade 3 or 4 nausea and vomiting. No cases of neutropenic sepsis were seen and there were no treatment-related deaths, however, six patients developed thrombotic complications. The overall response rate was 27% (CR 3%; PR 23%). Median time to progression was 3.4 months (95% CI 1.1-5.6 months) and median overall survival was 7.7 months (95% CI 5.7-9.8 months). Survival at 1 year was 28%, and at 2 years, 10%. MCF is a tolerable regimen with comparable toxicity, response rates and survival data to most platinum-based combination chemotherapy regimens in use for this devastating disease.
authors.affiliation: ANCHOR Unit, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, Scotland, UK. Graham.Macdonald@arh.grampian.scot.nhs.uk
authors.forename: A Graham
authors.initials: AG
authors.lastname: Macdonald
authors.forename: M C
authors.initials: MC
authors.lastname: Nicolson
authors.forename: L M
authors.initials: LM
authors.lastname: Samuel
authors.forename: A W
authors.initials: AW
authors.lastname: Hutcheon
authors.forename: F Y
authors.initials: FY
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary*; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy*; D016019:Survival Analysis
chemical_list: D016685:Mitomycin; D002945:Cisplatin; D005472:Fluorouracil