Mitomycin-C pulmonary toxicity
- Edward D Chan, MD
Edward D Chan, MD
- Professor of Medicine
- National Jewish Health
- Talmadge E King, Jr, MD
Talmadge E King, Jr, MD
- Editor-in-Chief — Pulmonary and Critical Care Medicine
- Section Editor — Interstitial Lung Disease
- Dean, School of Medicine
- Vice Chancellor, Medical Affairs
- University of California San Francisco
- Section Editor
- Kevin R Flaherty, MD, MS
Kevin R Flaherty, MD, MS
- Section Editor — Interstitial Lung Disease
- Associate Professor of Medicine
- University of Michigan Health System
- Deputy Editors
- Helen Hollingsworth, MD
Helen Hollingsworth, MD
- Deputy Editor — Pulmonary, Critical Care, and Sleep Medicine
- Associate Professor of Medicine
- Boston University School of Medicine
- Diane MF Savarese, MD
Diane MF Savarese, MD
- Senior Deputy Editor — UpToDate
- Deputy Editor — Oncology and Palliative Care
- Clinical Instructor of Medicine
- Harvard Medical School
Mitomycin-C (MMC), an antineoplastic antibiotic derived from Streptomyces caespitosus, is a cell cycle-specific alkylating agent . 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:
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- Agrawal N, Morrison GA. Laryngeal cancer after topical mitomycin C application. J Laryngol Otol 2006; 120:1075.
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- Flam M, John M, Pajak TF, et al. Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J Clin Oncol 1996; 14:2527.
- INCIDENCE AND SCOPE
- ACUTE LUNG INJURY
- Clinical manifestations
- INTERSTITIAL PNEUMONITIS
- Clinical manifestations
- THROMBOTIC MICROANGIOPATHY AND ACUTE RESPIRATORY FAILURE
- PULMONARY HYPERTENSION AND VENO-OCCLUSIVE DISEASE
- PLEURAL DISEASE
- LOCAL EFFECTS OF LARYNGOTRACHEAL MMC
- SUMMARY AND RECOMMENDATIONS