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Mitomycin-C pulmonary toxicity

Authors
Edward D Chan, MD
Talmadge E King, Jr, MD
Section Editors
Kevin R Flaherty, MD, MS
James R Jett, MD
Deputy Editors
Helen Hollingsworth, MD
Diane MF Savarese, MD

INTRODUCTION

Mitomycin-C (MMC), an antineoplastic antibiotic derived from Streptomyces caespitosus, is a cell cycle-specific alkylating agent [1]. Although it is active against a wide variety of tumors, newer agents have largely replaced MMC except in anal cancer; outside of the United States, MMC is infrequently used for treatment of advanced non-small cell lung cancer (NSCLC), and breast cancer. As with many other chemotherapeutic agents, most of the adverse effects of MMC are dose-related, including myelosuppression (which is typically delayed in onset), nausea, vomiting, diarrhea, stomatitis, dementia, and alopecia [1-3]. Pulmonary toxicity associated with MMC is unpredictable, but more likely to occur at higher doses.

The pulmonary complications associated with MMC therapy will be reviewed here. A general discussion of the clinical presentation, pathogenesis, diagnosis, differential diagnosis, and management of antineoplastic agent-induced pulmonary toxicity is presented separately. (See "Pulmonary toxicity associated with systemic antineoplastic therapy: Clinical presentation, diagnosis, and treatment".)

INCIDENCE AND SCOPE

Pulmonary toxicity associated with MMC is unpredictable, but more likely to occur at higher doses (in most literature reviews, >20 mg/m2) [4-7]. The frequency of clinically significant adverse pulmonary reactions from MMC is estimated to be between 2 and 12 percent [4,7-9].

The various pulmonary disorders that have been described with MMC include:

Acute bronchospasm

                  

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Literature review current through: Nov 2016. | This topic last updated: Fri Sep 16 00:00:00 GMT+00:00 2016.
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