Mitomycin C, 5-fluorouracil and folinic acid (Mi-Fu-Fo) as salvage chemotherapy in breast cancer patients with liver metastases and impaired hepatic function: a phase II study

Abstract

Patients with measurable liver metastases due to breast cancer and elevated liver enzymes were enrolled into the study. The planned schedule was mitomycin C 8 mg/m2 on day 1, 5-fluorouracil 750 mg/m2 and folinic acid 300 mg/m2 on day 1 and 2 every 4 weeks (Mi-Fu-Fo). Between May 1998 and December 2002, 30 patients with a median age of 51 years (range 33-74) were enrolled. All of them suffered from extensive metastases of the liver resulting in liver dysfunction. Myelosuppression was the most frequent toxicity. Six patients had a partial remission, 12 patients had stable disease and 12 patients progressed during treatment. The median time to progression was 4.5 months in all patients and 7.0 months in patients who responded to the therapy. The median overall survival for the total population was 6.0 months and in the group of responding patients 12.0 months. Mi-Fu-Fo, therefore, provides a valid option for breast cancer patients with liver dysfunction due to liver metastases.

Capecitabine and Mitomycin C Is an Effective Combination for Anthracycline- and Taxane-Resistant Metastatic Breast Cancer

“…Mitomycin C is a drug employed for years in combination with many other cytotoxic drugs (for example, vinca alkaloids, alkylating agents, antimetabolites) as salvage therapy for anthracycline- and taxane-resistant breast cancer [14, 15, 21]. Response rates of between 30 and 40% have been achieved with such regimens despite heavy pretreatment [14, 15].…”

Combined Chemotherapy with Mitomycin C, Folinic Acid, and 5-Fluorouracil (MiFoFU) as Salvage Treatment for Patients with Liver Metastases from Breast Cancer – a Retrospective Analysis

“…Reduced liver function was clinically defined as the presence of hepatomegaly, jaundice, or formation of ascites. Furthermore, according to previously published criteria [39], patients in whom serum levels of liver enzymes (alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), γ-glutamyltransferase (GGT)) were elevated above 3 times the upper normal limit (≥ 3 UNL) or ≥ 1.5 UNL plus alkaline phosphatase (AP) ≥ 1.5 UNL were also included in this group. Table 4 provides an overview of the main patient characteristics.…”

“…Particularly in patients with hepatic dysfunction, this regimen seems to represent a helpful treatment option. over, a combination chemotherapy consisting of MMC, folinic acid, and 5-FU (MiFoFU) has been shown to be active and safe in the treatment of patients with advanced liver metastases secondary to breast cancer and hepatic dysfunction [39]. The aim of this retrospective analysis was to study the activity and tolerability of MiFoFU combination chemotherapy in a larger cohort of patients with liver metastases from breast cancer.…”

Successful Remission of Extensive Liver Metastases in a Breast Cancer Patient with Acute Liver Failure Using a Combined Chemotherapy Regimen with Mitomycin, Folinate, and 5-Fluorouracil (Mi/Fo/FU)

“…Forpatientswithapoorclinicalperformancestatus,theadministrationofchemotherapyhastobe discussedcarefully,as thebenefitcanbeonlymarginal. Patientswithjaundiceareat higherriskfortoxicity,andtreatmentoptionsthereforehave tobeanalyzedindetail.AcombinationchemotherapyconsistingofMi/Fo/FUhasbeenshowntobeactiveandsafeinthe treatmentofpatientswithadvancedlivermetastasessecondary to breast cancer and hepatic dysfunction [7]. Eichbaum etal.…”

“…patients with predominant liver metastases with a clinical benefit for the combined chemotherapy with Mi/Fo/FU at a rateof58%;similardataareshownon44patientswithaclini-calbenefitof64% [9].Abenefitofupto50%andamedian overallsurvivalof12.0monthsunderthetreatmentwithMi/ Fo/FU in patients with impaired hepatic function were reportedbyLoibletal. [7].Insummary,Mi/Fo/FUseemstobe awelltoleratedregimen.Inourcase,theMi/Fo/FUregimen was used as a salvage treatment for a breast cancer patient withhepaticfailure.Theaimsoftherapyinthepalliativesetting, such as relief of symptoms, improvement of quality of life,possibleprolongationofsurvival,andtherapyadministrationinanoutpatientsetting,couldsuccessfullybeachieved.…”