Mitomycin is an antibiotic sometimes used as a chemotherapy drug. It can be used to treat mesothelioma. Several studies show that mitomycin stabilizes the disease and reduces symptoms of mesothelioma in some patients, usually when combined with other chemotherapy drugs.
What Is Mitomycin?
Mitomycin is an antibiotic used in cancer treatment as part of chemotherapy. The U.S. Food and Drug Administration (FDA) approved it to treat metastatic pancreatic and stomach cancers. t is administered intravenously, approximately every six to eight weeks.[1]
What Kind of Chemo Is Mitomycin?
Although it is an antibiotic, a medication usually used to treat bacterial infections, mitomycin is only used for cancer treatment.
It comes from a substance isolated from the Streptomyces caespitosus bacteria, and it works by slowing or stopping the growth of cancer cells. Other chemotherapy drugs kill or destroy cancer cells.
How Does Mitomycin Work?
Mitomycin kills cancer cells by generating radicals, compounds that interact with and change DNA. In cancer cells, these radicals cross-link DNA molecules. This prevents the cells from replicating, which serves to slow down or potentially stop tumor growth.[2]
What Is Mitomycin Used For?
Oncologists may turn to mitomycin as part of chemotherapy treatment for patients with specific types of cancer that have not responded well to other chemotherapy drugs, radiation therapy, or surgery.
Mitomycin is given with other chemotherapy drugs. The dosing and the exact combination of drugs vary depending on the individual patient, the type and extent of the cancer, and previous treatments.
The FDA approved mitomycin to treat some patients with stomach or pancreatic cancer. It is also used in palliative care for patients who have not responded to other treatments.
Off-label uses for mitomycin include mesothelioma, non-small cell lung cancer, cervical cancer, and bladder cancer.
Who Should Not Use Mitomycin?
Mitomycin is not considered a stand-alone cancer treatment. It should not be used in patients who are sensitive to it or in those with low platelets and clotting disorders. Mitomycin can reduce platelets even more.[3]
What Are the Side Effects of Mitomycin?
Mitomycin is toxic to cancer cells and healthy cells. It can cause a lot of damage to the body, including side effects and serious adverse events.
Common Side Effects of Mitomycin
Talk to your doctor if you experience any of these more common side effects of mitomycin:[4]
- Nausea
- Vomiting
- Loss of appetite
- Hair loss
- Increased risk of infections
- Skin rash
- Tiredness
- Numbness in fingers and toes
- Headaches
- Blurred vision
Serious Side Effects
Seek medical attention immediately if you have any of these responses to mitomycin:[4]
- Shortness of breath or difficulty breathing
- A fast or irregular heartbeat
- Blisters, sores, swelling, itching, and pain on the skin, especially at the site of injection
- Lower back or side pain
- Difficult urination
- black, tarry, or bloody stool
Mitomycin Toxicity
The toxic nature of mitomycin can cause several secondary health problems in some patients:[3]
- Bone marrow suppression – reduction in blood cells, which can affect blood clotting and reduce immunity, resulting in serious, even life-threatening infections
- Kidney or bladder toxicity – damage to the kidneys or the bladder, which can result in stones
- Pulmonary toxicity – damage to the lungs is rare but possible
- Fertility impairment – reduction in sperm count in men and fertilization and implantation in women
- Hemolytic uremic syndrome – damage to blood vessels in the kidneys that causes clots and can lead to fatal kidney failure
Can Mesothelioma Be Treated with Mitomycin?
The chemotherapy drugs most often used to treat mesothelioma are pemetrexed, cisplatin, carboplatin, gemcitabine, and vinorelbine. Patients usually receive a combination of more than one drug for better results. Pemetrexed and cisplatin are most commonly combined for mesothelioma treatment.[5]
- Mitomycin and cisplatin. The earliest studies investigating the usefulness of mitomycin for mesothelioma treatment used laboratory mice. In one early study, mice were implanted with human mesothelioma cells. The combination treatment of mitomycin with cisplatin was found to be most effective. Based on this finding, the researchers then used this pairing in twelve human patients, and four responded to it, with three partial responses and one complete response.[6]
- Mitomycin, cisplatin, and antiviral drugs. Since that study, several more have investigated using mitomycin with cisplatin and various other drugs. In one study, the patients were given the two drugs and the immunotherapy drug alpha-2b-interferon, which stimulates the immune system to help fight cancer. Some participants had good results, while others experienced cancer progression despite the new treatment regimen. The researchers concluded that the interferon was not helpful, though it trended towards a possible improvement if more patients had been enrolled in the study.[7]
- Mitomycin, cisplatin, and irinotecan. In another study, researchers combined mitomycin and cisplatin with irinotecan, a chemotherapy drug used most often for colon and rectal cancers. They enrolled forty-nine pleural mesothelioma patients to receive this combination treatment. Most saw a good response to the treatment with no disease progression. Just four patients continued to have disease progression, with a few patients not reported. The researchers concluded that this combination could be an effective first-line treatment to slow the spread of mesothelioma.[8]
- Mitomycin, cisplatin, and vinblastine. This combination may help mesothelioma patients get symptom relief with palliative treatment. Palliative care is the management of symptoms for patients with advanced cancer. Researchers found that most of the thirty-nine mesothelioma patients in palliative care tolerated the combination well, and twenty-four saw significant reductions in cancer symptoms, especially pain.[9]
Mitomycin and Mesothelioma Clinical Trials
Mitomycin isn’t involved in many studies with mesothelioma patients. Currently, one clinical trial is using mitomycin as part of treatment and is actively recruiting peritoneal mesothelioma patients.
Study participants undergo cytoreductive surgery followed by HIPEC. HIPEC is a treatment that circulates heated chemotherapy drugs throughout the abdominal cavity as an alternative to an intravenous injection.
The trial includes four different treatment groups. The researchers vary the chemo drugs given to patients to find the best combination. Patients in two groups are getting mitomycin in combination with other medications.[]
Not everyone responds the same way to chemotherapy drugs and combinations. While mitomycin used with other medications may provide good results for some patients, it doesn’t work for others. Combining this antibiotic with other chemotherapy drugs for patients with mesothelioma is an opportunity, but the research is still limited. Talk to your doctor about using mitomycin or any clinical trials that are currently using the drug.
