Mitomycin C (MMC) with weekly 24-hour infusions of high-dose 5-fluorouracil and leucovorin in patients with advanced gastric cancer.
BACKGROUND
We have reported a 33% response rate with 5-fluorouracil/leucovorin (5-FU/LV) treatment along with a median survival of 7 months in patients with advanced gastric cancer. Subsequently, mitomycin C (MMC) became our target agent for the combination because of its activity towards gastric cancer.


METHODS
From May 1998 to December 2000, a total of 37 chemo-naive patients with advanced gastric cancer were included. There were 20 men and 17 women with a median age of 58 (range, 21-73) years. The regimen consisted of 2600 mg/m2 5-FU and 100 mg/m2 LV admixed in an outpatient infusion pump administered for 24 hours every week for 6 weeks, followed by a 2-week break; then 10 mg/m2 MMC was given once every 8 weeks. The treatment continued until disease progression or unacceptable toxicity was noted, or the patient refused.


RESULTS
In total, 404 treatments of 5-FU/LV were given. The mean number of treatments was 10 (range, 1 to 24). The intent to treat response rate was 40.5% (15/37) with 5.4% (2/37) showing a complete response. The median time to disease progression was 4.5 months. The median survival time was 8.0 months. All of the patients were evaluated for toxicity. Less than 10% of the patients developed grade III/IV toxicity.


CONCLUSIONS
MMC with weekly 24-hour infusions of high-dose 5-FU and LV produced moderate activity in patients with advanced gastric cancer, and patients showed acceptable toxicity.
Chen
Jen-Shi
JS
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei. fong0301@ms18.hinet.net
Lin
Yung-Chang
YC
Liau
Chi-Ting
CT
Wang
Cheng-Hsu
CH
Liaw
Chung-Chi
CC
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D016685:Mitomycin; D002955:Leucovorin; D005472:Fluorouracil