Mitomycin Accord Healthcare (Mitomycin)

Mitomycin is employed in chemotherapy regimens for several solid‑tumour types.

• Gastric cancer: used as part of combination chemotherapy to improve response rates.
• Pancreatic cancer: incorporated into multi‑agent protocols to enhance tumour control.
• Bladder cancer: administered intravesically or systemically for advanced disease.
• Breast cancer: combined with other agents to increase cytotoxic effect.
• Head and neck cancer: used in concurrent chemoradiation to boost local control.
• Non‑small cell lung cancer: added to regimens for metastatic disease.

• Mitomycin exerts its antineoplastic activity by undergoing enzymatic reduction within tumor cells, forming reactive intermediates that covalently cross‑link DNA strands. This cross‑linking blocks DNA replication and transcription, leading to inhibition of cell proliferation and ultimately triggering apoptotic cell death in rapidly dividing cancer cells.

Mitomycin may cause a range of adverse reactions, from mild to severe. Monitoring and supportive care are essential during therapy.

Common Side Effects

• Nausea and vomiting: gastrointestinal upset common during infusion.
• Myelosuppression: reduced white blood cells, platelets, and red cells.
• Alopecia: hair loss that may be temporary.
• Fatigue: generalized tiredness during treatment cycles.
• Mucositis: inflammation of the mouth and gastrointestinal lining.

Serious or Rare Side Effects

• Severe bone‑marrow suppression: can lead to life‑threatening infections.
• Pulmonary toxicity: interstitial pneumonitis or fibrosis.
• Hemolytic‑uremic syndrome: renal failure with hemolysis.
• Renal toxicity: acute kidney injury requiring monitoring.
• Cardiac toxicity: arrhythmias or myocardial injury.
• Severe infection: opportunistic infections due to immunosuppression.

Before initiating Mitomycin therapy, clinicians should assess patient suitability and monitor for potential complications.

• Blood counts: perform baseline and regular CBC to detect myelosuppression.
• Renal function: evaluate serum creatinine and adjust dosing if impaired.
• Hepatic function: check liver enzymes as hepatic impairment may increase toxicity.
• Pregnancy: avoid use; teratogenic risk is unknown and contraindicated.
• Infection risk: postpone treatment in the presence of active severe infection.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Mitomycin can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Concurrent myelosuppressive agents: may cause profound bone‑marrow toxicity.
• Nephrotoxic drugs (e.g., cisplatin, aminoglycosides): increase risk of renal injury.
• Radiotherapy: combined use can exacerbate tissue damage.

Moderate Interactions (Monitor Closely)

• Anticoagulants: heightened bleeding risk due to thrombocytopenia.
• CYP450 inhibitors/inducers: may affect metabolic activation of Mitomycin.
• Diuretics: can modify renal clearance and electrolyte balance.