Mitomycin Accord (Mitomycin)

Mitomycin is an antineoplastic antibiotic used in chemotherapy for solid tumours.

• Gastric cancer: improves disease control and may extend survival in advanced cases.
• Pancreatic cancer: used in combination regimens to reduce tumour burden and enhance response rates.
• Bladder cancer: administered intravesically or systemically to achieve tumour regression and prevent recurrence.
• Breast cancer: incorporated into multi‑agent protocols for metastatic disease to achieve partial or complete responses.

• Mitomycin exerts its antineoplastic effect by forming covalent cross‑links between DNA strands, which blocks DNA synthesis and transcription. This alkylating activity triggers apoptosis in rapidly dividing cancer cells while sparing most normal tissues, resulting in tumour cell death.

Mitomycin may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Nausea and vomiting: gastrointestinal upset occurring during or after infusion.
• Myelosuppression: reduced white blood cells, platelets, and red cells leading to infection risk.
• Alopecia: temporary hair loss during treatment cycles.
• Mucositis: inflammation of the mouth and gastrointestinal lining.
• Fatigue: generalized tiredness affecting daily activities.

Serious or Rare Side Effects

• Pulmonary fibrosis: progressive scarring of lung tissue causing breathing difficulties.
• Renal toxicity: impaired kidney function requiring monitoring of serum creatinine.
• Severe bone‑marrow suppression: life‑threatening pancytopenia.
• Hemolytic‑uremic syndrome: rare clotting disorder with kidney failure.
• Anaphylactic reactions: immediate hypersensitivity requiring emergency care.

Mitomycin requires careful monitoring and patient selection to minimise risks.

• Monitor blood counts: perform regular CBCs to detect myelosuppression early.
• Assess renal function: check serum creatinine and urine output before each dose.
• Evaluate pulmonary status: baseline lung function tests are advised for patients with pre‑existing lung disease.
• Avoid use in active severe infection: postpone treatment until infection is controlled.
• Use effective contraception: both male and female patients should employ reliable birth control during therapy and for a defined period afterward.
• Store at controlled room temperature: keep in original container, protect from light and moisture.

Mitomycin can interact with other medicines, altering its safety or effectiveness.

Major Interactions (Avoid)

• Concurrent alkylating agents: additive toxicity to bone marrow and organs.
• High‑dose radiation therapy: increased risk of severe tissue damage.

Moderate Interactions (Monitor Closely)

• Nephrotoxic drugs (e.g., cisplatin, aminoglycosides): may exacerbate kidney injury.
• Other myelosuppressive agents (e.g., methotrexate, vincristine): require close blood‑count monitoring.
• Anticoagulants (e.g., warfarin, heparin): heightened bleeding tendency.
• CYP450 modulators: may affect mitomycin metabolism and plasma levels.