Salvage chemotherapy in metastatic colorectal cancer with the combination of capecitabine and mitomycin C.

A significant proportion of heavily pretreated patients with metastatic colorectal cancer maintain good performance status (PS) and are eligible for further systemic treatment. Mitomycin C (MMC) combined with capecitabine can be considered as salvage treatment in this group of patients. To evaluate the efficacy and toxicity of mitomycin C and capecitabine as at least third-line systemic therapy (after failure of 5Fu, irinotecan, oxaliplatin-based chemotherapy regimens and targeted therapies) in patients with metastatic colorectal cancer. A total of 31 patients with a median age of 55.2 years with metastatic colorectal cancer received salvage chemotherapy at the Oncological Department of University Hospital in Krakow, Poland, between July 2011 and July 2014. Chemotherapy consisted of intravenous MMC 6 mg/m2 on day 1 and oral capecitabine 1000 mg/m2 twice daily on days 1-14 followed by a 7-day treatment-free interval. Each cycle was repeated every 3 weeks unless there was evidence of disease progression or unacceptable toxicity. All the31 patients were evaluable for response and toxicity. A total of 113 cycles were administered. Five of the 31 (16.1%) patients had stable disease after three cycles of chemotherapy, 24 (77.4%) patients progressed and 1 (3.2%) patient is still undergoing treatment. One patient (3.2%) died due to cardiac infarct 5 days after starting treatment. Median progression free survival (PFS) was 2.5 months. Median overall survival (OS) was 4.9 months. Toxicity was mild and easily manageable. Mitomycin C and capecitabine can be considered as salvage therapy in heavily pretreated patients with metastatic colorectal cancer and with good performance status. Toxicity of these drugs combination is moderate and easily manageable.