First-Line Chemotherapy of Advanced Breast Cancer with a Combination of Mitoxantrone, Methotrexate, and Vincristine (MIMO)

Samonis, George; Bafaloukos, Dimitrios; Margioris, Andrew N.; Katsarma, G.; Toloudis, P; Bacoyannis, C.; Karvounis, N.; Georgoulias, V.; Kosmidis, P.

doi:10.1159/000227721

Oncology

1997

DOI: 10.1159/000227721

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First-Line Chemotherapy of Advanced Breast Cancer with a Combination of Mitoxantrone, Methotrexate, and Vincristine (MIMO)

George Samonis

Dimitrios Bafaloukos²,

Andrew N. Margioris³

et al.

Abstract: Fifty-one patients with advanced breast cancer entered a prospective study of combination chemotherapy, consisting of mitoxantrone (10 mg/m²), methotrexate (30 mg/m²), and vincristine (1 mg/m², MIMO) given intravenously every 21 days. None of the patients had received prior chemotherapy for metastatic disease, although 24 had been previously given adjuvant chemotherapy. Forty-seven patients were analyzed for response and toxicity. Objective response was observed in 20 of them (… Show more

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Pharmacokinetics and efficacy of pemetrexed in patients with brain or leptomeningeal metastases

Kumthekar¹,

Grimm

Avram³

et al. 2013

J Neurooncol

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Brain metastases (BM) and leptomeningeal metastases (LM) are devastating neurologic complications. Pemetrexed is a multi-targeted anti-folate agent approved for treatment of nonsquamous non-small cell lung cancer but has anti-tumor activity in other solid tumors. We performed two trials using pemetrexed in patients with BM and LM to assess CSF penetration and anti-tumor activity. Patients were treated with intravenous pemetrexed at doses of 500 (n = 3), 750 (n = 3), 900 (n = 12) or 1,050 mg/m(2) (n = 3) every 3 weeks. Neuro-imaging was done every 6 weeks. Matched CSF and plasma samples were obtained serially from three patients with Ommaya reservoirs; the remaining patients had a single paired collection. Twenty-one patients (15 women and six men) with median age of 50 years and median KPS of 90 were treated. Primary tumors included breast (13), lung (4), colorectal (1), endometrial (1), esophageal (1) and pinealoblastoma (1). Nine patients had prior whole brain RT and median number of prior chemotherapies was two including prior methotrexate in four patients. Median pemetrexed doses administered was three (range 1-14). Responses included one partial response, ten stable disease and ten progressive disease. Median time to progression and survival was 2.7 and 7.3 months; PFS six was 22 %. No major toxicities were seen. Pemetrexed distributed from the plasma to the CSF within 1-4 h with the resulting CSF concentrations < 5 % of plasma. Pemetrexed was tolerated in solid tumor patients with CNS metastases. Limited anti-tumor activity was seen, which might have been due to low CSF concentrations, although some patients displayed prolonged benefit.

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Pharmacokinetics and efficacy of pemetrexed in patients with brain or leptomeningeal metastases

Kumthekar¹,

Grimm

Avram³

et al. 2013

J Neurooncol

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First-Line Treatment With Mitoxantrone, Methotrexate, Vincristine, and Carboplatine (MIMOC) Plus Cyclical Hormonotherapy With Tamoxifen and Megestrol Acetate in Advanced Breast Cancer

Kakolyris

Samonis

Koukourakis

et al. 1999

American Journal of Clinical Oncology

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Fifty patients with stage IIIB and IV breast cancer entered a prospective study receiving combination chemotherapy consisting of mitoxantrone (8 mg/m2) on day 1, methotrexate (30 mg/m2) on day 1, vincristine (1 mg/m2) on day 2, and carboplatine (250 mg/m2) on day 2 (MIMOC), plus cyclical hormonotherapy with tamoxifen (20 mg daily, days 1-10) and megestrol acetate (160 mg daily, days 11-21). The regimen was repeated every 3 weeks. None had received chemotherapy for advanced disease, although 17 patients had previously received adjuvant chemotherapy and 21 had received adjuvant hormonotherapy with tamoxifen. Twenty-seven patients had positive estrogen receptor (ER+) status, and 23 negative estrogen receptor (ER-) status. Response was observed in 31 (62%) of the 50 analyzed patients (95% CI: 48.5-75.4%), with 5 complete responses (10%). A significantly better response rate was observed in ER+ patients (p = 0.03). The median duration of response was 16 months, and the median time to disease progression was 18 months. The median overall survival was 19 months (27 for responders and 7 for nonresponders). ER+ patients had a higher probability of survival (p = 0.02). Toxicity was moderate. Nausea/vomiting and myelotoxicity were the main side effects. In conclusion, MIMOC plus cyclical hormonotherapy represents a well-tolerated and effective first-line treatment for advanced breast cancer. The observed difference in response and survival in favor of ER+ patients warrants further investigation.

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First-Line Chemotherapy of Advanced Breast Cancer with a Combination of Mitoxantrone, Methotrexate, and Vincristine (MIMO)

Cited by 2 publications

References 4 publications

Pharmacokinetics and efficacy of pemetrexed in patients with brain or leptomeningeal metastases

Pharmacokinetics and efficacy of pemetrexed in patients with brain or leptomeningeal metastases

First-Line Treatment With Mitoxantrone, Methotrexate, Vincristine, and Carboplatine (MIMOC) Plus Cyclical Hormonotherapy With Tamoxifen and Megestrol Acetate in Advanced Breast Cancer

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