Mitomycin-C

Solid tumours Suggested regimen : Initial: 10-20 mg/m 2 ; may repeat 6-8 wkly depending on blood count. Do not repeat if leucocyte and platelet counts are below acceptable levels. Do not re-administer if the nadir of the leucocyte count is <2,000 cells/mm 3 Intravesical Superficial bladder tumours : Instill 10-40 mg 1 -3 times/wk for a total of 20 doses Prevention of recurrent bladder tumours : Instill 20 mg 2 wkly or 40 mg 1-3-mthly.

Mitomycin is an antineoplastic antibiotic which is enzymatically reduced to its active metabolite within susceptible cells. The active metabolite appears to cause cross-linking of DNA (primarily with guanine and cytosine pairs). It is also active against gm+ve bacteria and some viruses.

Hemolytic uremic syndrome (<15%), Myelosuppression (64%), Nausea/ vomiting (14%), Fever (14%), Stomatitis (4%), Increased serum creatinine (2%), Mucous membrane toxicity (4%) , Fatigue, Pulmonary toxicity, Dyspnea, Cystitis, Interstitial fibrosis, Nephrotoxicity, Amenorrhea, Alopecia, Myelosuppression, haemolytic-uraemic syndrome.

Hypersensitivity. Patient with platelet counts <100,000/mm3, leukocyte counts <4,000/mm3 or serum creatinine concentration >1.7 mg/dL. Patient with substantial prolongation of prothrombin time or bleeding time, coagulation disorders, increased bleeding tendency. Pregnancy and lactation.

Repeated haematologic studies are necessary during treatment and for at least 7 wk after discontinuation of the drug. Discontinue use when the leucocyte count decreases to <4000/mm 3 or the platelet count decreases to <150,000/mm 3 or if a progressive decline in either occurs. Monitor patient for signs of renal or pulmonary toxicity.

Increased incidence of cardiotoxicity with doxorubicin.