Hortobagyi G N
University of Texas M.D. Anderson Cancer Center, Department of Medical Oncology, Houston 77030.
Oncology. 1993 Apr;50 Suppl 1:1-8.
Investigators have compiled extensive experience with mitomycin in the treatment of patients with breast cancer. Given as a single agent in intermittent schedules, mitomycin has induced responses of 26-38% in previously untreated patients and of 15-25% in those exposed to multiple prior chemotherapy regimens. Duration of response has been short. Toxicity, primarily myelosuppression, is largely dose-dependent. The dose-dependent efficacy of mitomycin has not yet been addressed. Preclinical studies suggest that optimal single-agent results are obtained when mitomycin is given in intermittent, high-dose schedules. Combination chemotherapy with mitomycin has proven more effective than single-agent therapy. Mitomycin given in combination with doxorubicin produces higher response rates than have been obtained with mitomycin alone. The 3M combination (mitomycin/mitoxantrone/methotrexate) appears effective and well tolerated at the doses described. Future research should focus on the development of polychemotherapeutic regimens that can be delivered in sequential or alternating schedules. Such regimens may yield quicker responses, and thus improve survival, in patients with breast cancer.
研究人员在丝裂霉素治疗乳腺癌患者方面积累了丰富经验。丝裂霉素作为单一药物采用间歇给药方案时，在既往未接受过治疗的患者中诱导的缓解率为26% - 38%，在接受过多种先前化疗方案的患者中为15% - 25%。缓解持续时间较短。毒性主要为骨髓抑制，在很大程度上取决于剂量。丝裂霉素的剂量依赖性疗效尚未得到研究。临床前研究表明，当丝裂霉素采用间歇、高剂量给药方案时可获得最佳单药治疗效果。丝裂霉素联合化疗已被证明比单药治疗更有效。丝裂霉素与阿霉素联合使用产生的缓解率高于单独使用丝裂霉素时。3M联合方案（丝裂霉素/米托蒽醌/甲氨蝶呤）在所描述的剂量下似乎有效且耐受性良好。未来的研究应集中在开发可采用序贯或交替给药方案的多药化疗方案。此类方案可能使乳腺癌患者获得更快的缓解，从而提高生存率。
