5 FU infusion with mitomycin-C vs. 5 FU infusion with methyl-CCNU in the treatment of advanced upper gastrointestinal cancer. A Southwest oncology group study

Abstract

A randomized trial was conducted by the Southwest Oncology Group (SWOG) in advanced carcinoma of the stomach and pancreas. Patients were assigned to receive monthly 5-fluorouracil 96-hour continuous infusions with either bolus mitomycin-C or oral methyl-CCNU. Mitomycin-C and methyl-CCNU were administered every eight weeks. The 5 FU-mitomycin combination produced a 14% and 22% response rate in disseminated stomach and pancreatic carcinoma, respectively. The combination of infusion 5 FU and methyl-CCNU achieved responses in 9% and 5% of stomach and pancreatic tumors, respectively. There was no significant difference in survival between limbs for either tumor. Median survival in gastric carcinoma on the 5 FU-mitomycin regimen was 25 weeks vs. 18 weeks on the 5 FU-METHYL-CCNU arm. In pancreatic carcinoma median survival on the mitomycin limb was 19 weeks as compared to 17 weeks on the methyl-CCNU program. Leukopenia was greater for the first course on the mitomycin limb. Regression analysis demonstrated that performance status was the most important pretreatment characteristic for predicting survival in both tumors. Neither 5 FU infusion combination appears to significantly alter the dismal prognosis of advanced upper gastrointestinal neoplasms.

Phase II study of the oxygen saturation curve left shifting agent BW12C in combination with the hypoxia activated drug mitomycin C in advanced colorectal cancer

“…Responses to MMC as a second line agent after 5-FU are likely to be low. This is suggested by several randomized comparisons of 5-FU to 5-FU plus MMC for treating colorectal cancer which failed to show additive effects (Buroker et al, 1978;Richards et al, 1986), although a small additive effect on response rather than survival was reported (Ross et al, 1997). However, only one response was observed in 72 patients treated with MMC after 5-FU in phase II trials (Hartmann et al, 1998;Migeod et al, 1988;Zaniboni et al, 1995).…”

Randomized trials in exocrine pancreatic cancer

“…Natomiast połączenie 5-FU z cisplatyną [77][78][79] oraz 5-FU z cisplatyną i interferonem [80] nie zwiększa przeżycia w porównaniu z samym 5-FU. Podobnie, terapie łączone obejmujące 5-FU i ifosfamid [81], 5-FU i CCNU [82] oraz 5-FU i mitomycynę C [83,84] nie zwiększają przeżycia w porównaniu z 5-FU w monoterapii. Siedem badań o stosunkowo dobrej jakości [85][86][87][88][89][90][91] dowodzi, że terapia FAM (5-FU, doksorubicyna, mitomycyna C) nie przynosi korzyści w zaawansowanym raku trzustki, a wręcz wiąże się ze zwiększoną toksycznością.…”

The Evolution of Fluoropyrimidine Therapy: From Intravenous to Oral

“…These compounds were also associated with frequent hematologic and renal toxicities [3][4][5][6][7] and consequently were not incorporated into standard chemotherapy regimens. With such limited therapeutic options, treatment for colorectal cancer tended to be nihilistic, few advances were made, and the outlook for patients with colorectal cancer was poor.…”