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Mitomycin

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Mitomycin, Mitomycin C, Mutamycin

  • See Also
  1. Antibiotic Chemotherapy
  2. Chemotherapy
  • Indications
  1. FDA Approved
    1. Gastric Cancer
    2. Pancreatic Cancer
  2. Off-Label
    1. Anal Cancer
    2. Bladder Cancer (superficial, intravesical instillation)
      1. Volpe (2010) Minerva Urol Nefrol 62(2):133-44 +PMID: 20562793 [PubMed]
    3. Cervical Cancer
    4. Esophageal Cancer
    5. Vulvar Cancer
  • Mechanism
  1. See Antibiotic Chemotherapy
  2. Mitomycin C is a methylazirinopyrroloindoledione Antineoplastic Antibiotic
    1. Isolated from the bacterium Streptomyces caespitosus
  3. Mitomycin C is more toxic to hypoxic cells
  4. Bioreduced Mitomycin C inhibits DNA synthesis (as well as RNA and Protein synthesis)
    1. Generates free radicals
    2. Alkylates DNA
    3. Induces DNA interstrand cross-links
  • Medications
  1. Mitomycin Injection Solution: 5, 20 and 40 mg vials
  • Dosing
  1. See other references for disease specific dosing protocols
  • Adverse Effects
  1. Adult Respiratory Distress Syndrome
  2. Alopecia
  3. Severe skin and soft tissue necrosis on extravasation
    1. Idarubicin is a strong Vesicant (causes Blistering)
  4. Hemolytic Uremic Syndrome
  5. Myelosuppression
  6. Nephrotoxicity
  • Safety
  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Renal Function Tests
  • Resources
  1. Mitomycin Injection Powder for Solution (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ff676355-313d-4575-8f2f-e4a1e9527477
  2. Mitomycin (StatPearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK562249/