title: Mitomycin-C in combination with fluoropyrimidines in the treatment of metastatic colorectal cancer after oxaliplatin and irinotecan failure.
abstract: OBJECTIVE
  To retrospectively evaluate the efficacy and tolerability of mitomycin-C (MMC) in combination with fluoropyrimidines as salvage 3rd -or 4th-line therapy in metastatic colorectal cancer (MCRC) patients.
  
  
  METHODS
  All patients in this study had previously failed oxaliplatin and irinotecan-based chemotherapy. Patients were treated with MMC (6 mg/m(2) intravenously/i.v.) on day 1 in combination with either oral UFT (500 mg/m(2)) and oral leucovorin (LV) (30 mg) on days 1-14 every 3 weeks (group A) or infusional 5-fluorouracil (5-FU) by deGramont regimen with i.v. LV (200 mg/m(2)) on days 1 and 2, every 2 weeks (group B).
  
  
  RESULTS
  Thirty-nine MCRC patients were analyzed. Twenty-two of them were in group A and 17 in group B. Thirty-three were evaluable for clinical efficacy. The clinical benefit in the intent-to-treat (ITT) population was 30.8%. Median progression free survival (PFS) was 6 months (95% confidence interval/ CI 4-8) and median overall survival (OS) 9 months (95% CI 6.5-11.5). Median PFS was 3 months (95% CI 2.4-3.6) in group A and 7 months (95% CI 5.1-8.9) in group B (p=0.009). Median OS was 7 months (95% CI 4.3-9.7) in group A and 12 months (95% CI 5.4-18.6) in group B (p=0.422). The combination of MMC and fluoropyrimidines was generally well tolerated. The most common severe toxicities were nausea and vomiting, neutropenia, hepatotoxicity and diarrhea.
  
  
  CONCLUSIONS
  MMC in combination with fluoropyrimidines is safe and active in heavily-pretreated MCRC patients. This combination remains a viable option in these patients. However, better therapies are urgently needed.
authors.affiliation: Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Research and Education Hospital, Ankara, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Alkis
authors.forename: U
authors.initials: U
authors.lastname: Demirci
authors.forename: M
authors.initials: M
authors.lastname: Benekli
authors.forename: U
authors.initials: U
authors.lastname: Yilmaz
authors.forename: A
authors.initials: A
authors.lastname: Isikdogan
authors.forename: A
authors.initials: A
authors.lastname: Sevinc
authors.forename: N Y
authors.initials: NY
authors.lastname: Ozdemir
authors.forename: D
authors.initials: D
authors.lastname: Koca
authors.forename: T
authors.initials: T
authors.lastname: Yetisyigit
authors.forename: M A
authors.initials: MA
authors.lastname: Kaplan
authors.forename: D
authors.initials: D
authors.lastname: Uncu
authors.forename: T
authors.initials: T
authors.lastname: Unek
authors.forename: M
authors.initials: M
authors.lastname: Gumus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D016879:Salvage Therapy; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005641:Tegafur; D016685:Mitomycin; D014498:Uracil; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin