A sequential combination of bleomycin and mitomycin C in the treatment of advanced squamous cancers

The 49 patients with squamous cell type of cervical, lung, esophagus and head and neck cancers were treated with a sequential combination of bleomycin (BLM) and mitomycin C (MMC) as follows; 5 mg of BLM daily for 5 or 7 days followed by a single injection of 10 mg of MMC on day 6 or day 8. After one week of rest period, this course was repeated two to five times depending on the response or adverse effects. For cervical cancer, 17 patients out of 18 (94%) responded with complete remission (CR) in 13 (72%) and partial remission (PR) in 4 (22%). For lung cancer, four patients out of five responded. In two of the responders, metastatic tumors disappeared completely, but primary tumors decrease to about 10% in volume. For esophagal cancer, one patient out of 3 had CR after combining the BLM and MMC treatment with radiotherapy. For head and neck cancer, these were some differences in the response rates between two hospitals. In one hospital, 12 patients out of 22 (53%) responded, with CR in 4 (18%), whereas in the other hospital, 10 patients out of 11 (94%) responded, including eight with CR (72%). Regarding the toxicity, the overall incidence was very low, although lung complications were frequent. These results are promising with hopeful prospects for the control of advanced squamous cancers with metastasis.