Mitomycin C: New Strategies to Improve Efficacy of a Well-Known Therapy

Ragonese, Mauro; Racioppi, Marco; Bassi, Pierfrancesco; Gianfrancesco, Luca Di; Lenci, Niccolò; Filianoti, Alessio; Recupero, Salvatore

doi:10.5301/uro.5000193

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…The optimal dose and course of treatment when MMC is used as an adjuvant infusion therapy remain controversial. The 3-5 year recurrence rate in patients treated with MMC is only 8% lower than that of patients treated with TURBT [8]. Therefore, it is particularly urgent and important to improve the perfusion efficiency of MMC.…”

Section: Introductionmentioning

confidence: 98%

“…Therefore, multiple repeated transurethral resections, intravesical chemotherapy, or intravesical immunotherapy are often needed after the initial surgery [7]. For patients with NMIBC who are at a high risk of recurrence, mitomycin C (MMC) or Basile Calmette-Guerin (BCG) perfusion therapy is the main form of treatment [8]. However, there is a shortage of available BCG products [9].…”

Section: Introductionmentioning

confidence: 99%

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The clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C after transurethral resection of bladder tumour in patients with nonmuscular invasive bladder cancer: A meta-analysis

Zhou

Liu²,

Mao³

et al. 2022

PLoS ONE

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Background This review and meta-analysis aimed to systematically evaluate the clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C (MMC) in patients with nonmuscular invasive bladder cancer (NMIBC) after transurethral resection of bladder tumour (TURBT). Methods The Embase, PubMed, CNKI, CBM, WANGFANG, VIP, Cochrane Library, and Clinicaltrial.com databases were searched for articles published before April 2022. The experimental group was treated with intravesical instillation of MMC assisted by equipment, including radiofrequency-induced thermochemotherapy, conductive thermochemical therapy, electromotive drug administration, or locoregional hyperthermia. The control group was treated with simple MMC perfusion. The outcomes of interest in the meta-analysis were recurrence, progression, side-effects, gross haematuria, and bladder irritation. Results A total of 15 studies that enrolled 1,190 patients were included in the meta-analysis. Compared to that of the control group, device-assisted intravesical instillation of MMC significantly reduced both tumour recurrence (odds ratio [OR] = 0.32, 95% confidence interval [CI] [0.24, 0.42], P <0.00001) and progression (OR = 0.29, 95% CI [0.12, 0.67], P = 0.004). There were no significant differences between the two groups in terms of safety (OR = 1.21, 95% CI [0.66,2.21], P = 0.54), bladder irritation (OR = 1.06, 95% CI [0.72,1.55], P = 0.78), or gross haematuria (OR = 1.11, 95% CI [0.64,1.94], P = 0.72). Conclusions Equipment-assisted intravesical instillation of MMC significantly reduced the recurrence and progression of patients with NMIBC who underwent TURBT and improved their quality of life. Given the significant heterogeneity in research quality and sample size among earlier studies, more prospective, multicentre, large sample randomized controlled trials are needed to supplement and verify this in the future.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

The clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C after transurethral resection of bladder tumour in patients with nonmuscular invasive bladder cancer: A meta-analysis

Zhou

Liu²,

Mao³

et al. 2022

PLoS ONE

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“…Its cytotoxic effect results from DNA cross-linking, which inhibits DNA synthesis and cell proliferation. 16 While MMC is a well-established treatment for low-risk NMIBC, 17 its effectiveness in high-risk patients remains a point of contention, thereby necessitating further investigation.…”

Section: Introductionmentioning

confidence: 99%

Comparative study between mitomycin C versus Bacillus Calmette-Guérin (BCG) in high-risk non-muscle-invasive bladder cancer

Zaza,

Salem,

El-Sadat

et al. 2023

Urologia

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Objectives: We aimed to compare the efficacy and adverse events of Bacillus Calmette-Guérin (BCG) versus Mitomycin C (MMC) in high-risk Non-Muscle-Invasive Bladder Cancer (NMIBC) patients. Methods: This randomized controlled study was conducted over 24 months in four hospitals in Egypt. A sample of 90 patients was randomly assigned to either treatment group, with procedures including baseline examinations, a single postoperative instillation of chemotherapy, a 6-week induction cycle of the assigned drug, and regular follow-up cystoscopies and upper urinary tract imaging. Treatment results and side effects were monitored, with data analyzed via Statistical Package for Social Sciences (SPSS). Results: No significant differences were observed in mean age or tumor characteristics ( p > 0.05). However, adverse reactions were significantly higher in the BCG group, including cystitis (40% vs. 17.78%, p = 0.020), hematuria (24.44% vs. 4.44%, p = 0.007), overall local reactions (75.56% vs. 26.67%, p < 0.001), fever (13.33% vs. 2.22%, p = 0.049), and fatigue (17.78% vs. 2.22%, p = 0.014). The MMC group had a slightly higher recurrence rate (28.89% vs. 17.78%, hazard ratio 1.89, 95% CI: 0.78–4.55, p = 0.15) with a shorter median time to recurrence (six vs. 12 months). Progression rates were similar (8.89% MMC vs. 4.44% BCG, p = 0.398). Conclusion: Although BCG and MMC have comparable efficacy in managing high-risk NMIBC, BCG demonstrated a higher rate of adverse reactions. Decision-making should consider this balance, patient preferences, and health status. Further research is needed for the validation and exploration of these findings.

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“…Mitomycin C, a chemotherapeutic agent, interacted with MX1. It is used to treat many cancer types [218][219][220][221]. A systems biological study revealed that mitomycin C interacted with MX1, a key protein in an IPIN, suggesting further studies in the role of the drug in antiviral stimulation [50].…”

Section: Potential Drugs To Cure Severe Covid-19 Patientsmentioning

confidence: 99%

Analysis of protein-protein interaction network from leukocyte transcriptomic profiles in severe COVID -19 patients

Sagulkoo

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Coronavirus disease 2019 (COVID-19) still provides global public health issues although several vaccines and antiviral agents have been developed. Some patients experience severe conditions needed medical intensive care, and some are dead due to the failure of treatments. Therefore, identifying the key genes and underlying molecular mechanisms is necessary to discover precisely targeted drugs. Analysis of protein-protein interaction (PPI) networks provides invaluable information to find disease mechanisms and effective alternative drugs. Hence, PPI network analysis based on leukocyte transcriptomic profiles of severe COVID-19 collected from Gene Expression Omnibus (GEO) DataSets was proposed for this study. A network diffusion method called Laplacian heat diffusion (LHD) algorithm was performed to construct an immune-related PPI network (IPIN). Furthermore, several network centrality measurements can identify 23 key genes from the IPIN. Subsequently, drug-gene interaction networks were constructed using database searching based on the key genes. There were 5 candidate drugs having the potential effect of interacting with the key genes. To find additional key genes and candidate drugs, two different leukocyte transcriptomic datasets were combined for the common PPI network construction. Centrality measurement and survival analysis were used to find and validate the further key genes. The analysis revealed 4 common key genes. The drug-gene interaction and molecular docking technique provided 2 further candidate drugs that interacted with the key genes. Additionally, miRNA-mRNA regulatory networks were built based on the PPI network to recognize 5 novel biomarkers for severe COVID-19 prediction. In conclusion, PPI network analysis can discover candidate biomarkers and drugs to predict�and treat severe COVID-19 patients.�

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Mitomycin C: New Strategies to Improve Efficacy of a Well-Known Therapy

Cited by 9 publications

References 25 publications

The clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C after transurethral resection of bladder tumour in patients with nonmuscular invasive bladder cancer: A meta-analysis

The clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C after transurethral resection of bladder tumour in patients with nonmuscular invasive bladder cancer: A meta-analysis

Comparative study between mitomycin C versus Bacillus Calmette-Guérin (BCG) in high-risk non-muscle-invasive bladder cancer

Analysis of protein-protein interaction network from leukocyte transcriptomic profiles in severe COVID -19 patients

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