Hortobagyi G N
Semin Oncol. 1985 Dec;12(4 Suppl 6):65-70.
Mitomycin-C, an antitumor antibiotic discovered in 1958, acts as a bifunctional alkylating agent. Initial clinical trials utilized a daily schedule of administration, which led to severe and protracted myelosuppression and inadequate evaluation of the antitumor spectrum of mitomycin-C. In the early 1970s, the intermittent high-dosage schedule of administration was developed: 20 mg/m2 of mitomycin-C intravenously, every 6 to 8 weeks. An overall response rate of 35% was reported by several investigators. Subsequently, other administration schedules were attempted without improvement in therapeutic index. More recently, mitomycin-C was used in combinations with other drugs. Combinations of mitomycin-C and one of the vinca alkaloids have produced response rates of approximately 30% to 40% in patients with extensive previous treatment. In patients not previously exposed to doxorubicin, combinations of mitomycin-C and doxorubicin have offered response rates of approximately 50%. Acute toxicities of mitomycin-C are tolerable and consist of mild nausea, vomiting, and anorexia. Chronic toxicities include cumulative myelosuppression--especially thrombocytopenia--pulmonary toxicity, renal toxicity, and occasionally cardiac toxicity. Mitomycin-C is an effective antitumor agent in breast cancer and should be carefully incorporated in the therapeutic strategy of this disease.
丝裂霉素C是1958年发现的一种抗肿瘤抗生素，起双功能烷化剂的作用。最初的临床试验采用每日给药方案，导致严重且持久的骨髓抑制，并且对丝裂霉素C的抗肿瘤谱评估不足。在20世纪70年代早期，开发了间歇高剂量给药方案：每6至8周静脉注射20mg/m²丝裂霉素C。几位研究者报告的总缓解率为35%。随后，尝试了其他给药方案，但治疗指数并未改善。最近，丝裂霉素C与其他药物联合使用。丝裂霉素C与一种长春花生物碱联合使用，在接受过广泛前期治疗的患者中产生了约30%至40%的缓解率。在先前未接触过阿霉素的患者中，丝裂霉素C与阿霉素联合使用的缓解率约为50%。丝裂霉素C的急性毒性是可耐受的，包括轻度恶心、呕吐和厌食。慢性毒性包括累积性骨髓抑制——尤其是血小板减少——肺毒性、肾毒性，偶尔还有心脏毒性。丝裂霉素C是乳腺癌的一种有效抗肿瘤药物，应谨慎纳入该病的治疗策略中。
