Retrospective review of mitomycin C use as third-line chemotherapy in metastatic colorectal cancer

Abstract

The aim of this review was to determine the therapeutic value of the combination of mitomycin C with either infusional 5-fluorouracil or oral capecitabine in metastatic colorectal cancer when used as third-line treatment or beyond in the setting of routine clinical practice. We retrospectively reviewed 18 patients with advanced colorectal cancer who received this combination at our institution after the failure of two lines of prior treatment. All the patients were assessable for toxicity and survival and 14 for tumor response. The median age of the patients was 61 (range 39-78). Of these, 72% were male and 78% had Eastern Cooperative Oncology Group performance status 0 or 1. Eighty nine percent of the patients had metastatic involvement of the liver and five patients had at least three sites of metastatic involvement. All patients had received at least two lines of chemotherapy and had progressed on an oxaliplatin-containing regimen. Most of the patients had previously received an irinotecan-containing regimen, and a third had received prior biological agents. Overall, none of the patients achieved either complete or partial responses. Two patients (11%) achieved stable disease and 12 patients (67%) had progressive disease. The median progression-free survival was 2.7 months (range 0.5-8.8) and the median overall survival was 5.4 months (range 1.3-31.2). This chemotherapy regimen was well tolerated with an acceptable toxicity profile. The results of our review confirm the low efficacy of combination mitomycin C in heavily pretreated Australian patients with advanced colorectal cancer. This review confirms that it has no role after two lines of modern combination chemotherapy regimens and recommends that focus should be placed on investigating newer agents for good performance status patients progressing after these treatments. © 2008 The Authors Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.