19597 Background: Breast cancer patients with an impaired liver function due to liver metastases have very limited, evidence based treatment options. Based on our experience with mitomycin C, 5Fu and folinate (Loibl et al. 2004), we wanted to improve this schedule by including the oral antimetabolite capecitabine. Methods: Breast cancer patients (pts) with liver metastases and elevated liver enzymes defined as AST/ALT = 3×UNL (group A) or liver enzymes = 1.5×UNL and AP = 3×UNL (group B) were enrolled. Further inclusion criteria were as follows: bidimensionally measurable disease, normal hematological values (WBCs = 3×109/L; platelets = 100×109/L; hemoglobin = 10 g/dL), normal renal function. A three weekly cycle with Mitomycin C 8 mg/m2 i.v. on day 1, capecitabine 2,000 mg/m2 day 1–14 and prednison 5 mg day 1–5 orally was given. Primary endpoint is the progression free survival (PFS) measured from the planned 44 eligible patients who received at least one cycle of Mi-Cap. Results: Between April 2004 and December 2006, 35 patients with a median age of 57.1 years (range, 39–76) were enrolled. 29 pts. received an adjuvant or neoadjuvant chemotherapy of whom 20 received anthracyclines and 6 a taxane containing regimen. 9 pts. had no chemotherapy for metastatic disease and 9 pts. had 3 or more chemotherapies for metastatic disease. At the start of chemotherapy 24 pts belonged to group A and 11 to group B and 12 pts had hyperbilirubinemia. 20 pts had liver involvement only. So far 109 cycles had been given. 29 pts. received more than one cycle, 6 pts. received the 6 preplanned cycles so far. Myelosuppression and hand foot syndrome are the most frequent toxicities. 4 patients had a documented partial remission, 18 patients had stable disease or are still under treatment, and 13 patients progressed during treatment. The median time to progression is 6.4 months in all patients who received at least one cycle. The median overall survival for the total population was 8.3 months. Conclusion: Mi-Cap can be safely given. Initial observations show that pts with a decrease in liver enzymes or bilirubin in the first two cycles had a longer PFS. No significant financial relationships to disclose.
Combined Chemotherapy with Mitomycin C, Folinic Acid, and 5-Fluorouracil (MiFoFU) as Salvage Treatment for Patients with Liver Metastases from Breast Cancer – a Retrospective Analysis
