gms | German Medical Science

Background: Following strict palliative intentions, monotherapies are actually preferred in the zytostatic treatment of patients with metastatic breast cancer and reduced performance. A combined chemotherapy containing mitomycin, 5-fluorouracil and folinate (MiFoFU) is a well established combination therapy within the treatment of metastatic breast cancer. The aim of this retrospective study was to better evaluate the efficacy and toxicity in patients with reduced performance prior to therapy (elder patients, relevant co-morbidities, heavy pretreatment).

Patients and Methods: We studied retrospectively the charts of n=76 patients who were treated with a MiFoFU-combination therapy at our clinic between 1997 and 2003 because of progressive metastatic breast cancer. The schedule was mitomycin 7 mg/m² on day 1, 5-fluorouracil 750 mg/m² and 500 mg folinic acid day 1 and 2 every four weeks. Primary endpoints were response and time-to-progression (TTP), secondary endpoints were overall-survival (OAS) and tolerability.

Results: Median age prior to treatment was 58 years. A median of 5 therapy cycles was administered per patient. Overall reponse rate (ORR) was 59 % (CR 6 patients, PR 29 patients, NC 9 patients, PD 30 patients). A mean time-to-progression of 3 months and a mean overall survival time of 19 months after MiFoFU-chemotherapy were found. N=17 patients had >= 2 palliative zytostatic treatments before, n=19 patients were older 65 years. An impaired liver function was found in n=8 patients. Elder patients survived on average 14 months, patients with liver dysfunction 11 months. Main non-hematological toxicity was stomatitis (21 %). Grade III hematotoxicity was only seen in 3 patients (4 %).

Conclusions: A combined chemotherapy consisting of mitomycin, folinate and 5-fluorouracil is a well tolerated treatment option in the palliative therapy of patients with metastatic breast cancer. Especially the favourable efficacy/ toxicity profiles in patients with reduced performance or heavy pretreatment make this combination therapy a considerable alternative within these settings.