Mitomycin-C - 1255391

certain spring
Posts:762

I am posting in case anyone out there - doctor or patient - has experience of using Mitomycin-C in the lung. I have a bronchial stent that keeps getting blocked with granulation tissue, and this has been suggested as a possible treatment, extrapolating from some success with stents in the eyes.
However my surgeon is concerned that it is not safe for use in the airway. The very limited literature is contradictory, with a Chinese study suggesting it is safe and one from the US (Texas) suggesting that it can lead to airway complications:
http://www.ncbi.nlm.nih.gov/pubmed/23328180
http://oto.sagepub.com/content/133/6/831.short
I would really appreciate hearing from anyone who knows about this.

Forums

catdander
Posts:

Hi certain spring, Let's start by asking Dr. Weiss. Since this is an out of the norm use no one person will have an answer as you know. I'll also ask Dr. Weiss if he has ideas of anyone else to bring into the conversation.

Are you having another stent put in or are you still working with the same one.

All xoxo,
Janine

dr. weiss
Posts: 206

I'm sorry. I have no experience with MMC being used for this indication; I was not even aware of it.

Dr West
Posts: 4735

Mitomycin C is an older chemo drug that is used in some outdated regimens for lung cancer, but I've only ever seen it given IV and also have no familiarity with it being administered within the airway directly. I suspect that there is very, very little information out there on its use in this capacity, I'm sorry to say.

-Dr. West

catdander
Posts:

certain spring's most recent post about her stent ending with her signature. "So here I am, having had four bronchoscopies in the last month, feeling a bit delicate and not very cheerful. Two of the operations were a success (unblocked the stent) and two of them weren’t – most recently on Wednesday. The granulation tissue has speeded up to the extent that one of the surgeons commented on its growth in a ten-day interval, which is scary. Clearly things cannot go on as they are. It is hard to credit that while the cancer is behaving itself, the stent – which was supposed to protect me from the cancer – is the big threat now.
We are now facing a Hobson’s choice: take out the stent (bleeding, inflammation, risk of airway collapse) or take out the lung (risk of death from surgery, doubts about healing in radiation-damaged tissue, risks of long-term pain etc etc). Everyone has been alarmingly candid about the downsides. There has also been complete candour (which I appreciate) about the fact that the doctors have no experience of such a situation, since people with stents don’t usually live this long. Another example of targeted therapies changing the landscape.
There have been suggestions that it might be possible to calm the growth of the granulation tissue with brachytherapy (internal and temporary blast of radiation introduced by putting radioactive beads in the airway) or with topical Mitomycin-C, a form of chemotherapy (about which I will post separately). Meanwhile I just have to keep getting up in the morning and hoping for the best.
49-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19, ALK negative. Started Tarceva (150mg), Feb 2011"

certain spring
Posts: 762

Thanks to all for the replies.
I daresay we will settle on something a little more conventional, but with GRACE you never know who is reading, so I thought it worth a try.

catdander
Posts:

I put your info up in case Dr. Farivar, our faculty thoracic surgeon from Swedish Cancer Institute had any input but just received email from him stating he didn't have any experience at all with stents.