Treatment of advanced gastrointestinal cancer with 5-fluorouracil and mitomycin C

Abstract

Fifty-one patients with metastatic and/or recurrent gastrointestinal cancer received a regimen of continuous 5-fluorouracil infusion and mitomycin C. Among patients with colorectal cancer, 9 (33%) showed tumor regression, 10 showed objective tumor response <50%, and 3 were evaluated as stable. While the median response duration of 5 months was relatively brief, 7 patients survived for 1 year or more and one is still alive >22 months after the onset of treatment. Three of 9 patients with gastric cancer were responders, one complete. The median survival was 11 months; 3 patients survived for 1 year or more, one for 21 months from the initiation of therapy. Half of 8 patients with pancreatic cancer showed some objective response, 3 with >50% tumor regression. Duration of response in these 3 cases is 5+, 10, and 10+ months. In our series, mild to moderate hematologic toxicity was encountered in 63% and tended to be cumulative. There were no serious infections, and 2 instances of prolonged thrombocytopenia. Partial alopecia developed in most patients; gastrointestinal toxicity was minimal. That this combination may cause pulmonary toxicity was suggested by the development of severe respiratory insufficiency without apparent cause in 3 patients, all of which had at least 2 cycles of treatment. A transient response to corticosteroids was obtained. One patient, free of tumor at autopsy, demonstrated a glomerular lesion previously described with mitomycin C toxicity, while 2 others developed a micro-angiopathic hemolytic anemia.