High-dose mitomycin C: activity in hepatocellular carcinoma

Hepatocellular carcinoma is the most common cause of cancer death in Thai males. It is usually found to be inoperable, and the reported median survival for Thai patients is only 4.3 months. From October 1984 to December 1986, 30 cases of nonresectable hepatocellular carcinoma were treated at the National Cancer Institute, Bangkok, Thailand, with high-dose mitomycin C. Patients were given 20-25 m/m2 (median, 40 mg) by i.v. injection, followed by 10-12.5 mg/m2 (median, 20 mg) at 6-week intervals in responding patients until the disease progressed or toxicity was detected. In all, 23 patients were evaluable by WHO criteria. A partial response was achieved in 11 of 23 cases (48%); the median duration of this response was 7 months (range, 3-11 months). The median cumulative dose of mitomycin C was 80 mg (range, 40-120 mg). Toxicity was relatively well tolerated; only one patient developed an unusual erythematous, reticular skin rash that spontaneously disappeared within 1 month of injection of the drug. The median survival of responders was 12 months, and the longest survival was 18+ months. We conclude that high-dose mitomycin C given according to the present dose and schedule has antitumor activity in hepatocellular carcinoma in Thai patients. Although its response rate is as high as that produced by doxorubicin, with less toxicity, no complete response was achieved in this study.