The role of mitomycin in the treatment of non small cell lung cancer: a systematic review with meta-analysis of the literature

In order to clarify the role of mitomycin (MMC) in the treatment of NSCLC, we performed a systematic review of the literature and qualitatively assess ed the selected studies using the ELCWP and Chalmers scales. 5 trials (202 patients) assessed the activity of MMC as single-agent chemotherapy in NSCL C. The overall response rate was 25% (95% CI 19-31). In 10 randomized phase III trials (1769 patients), we studied the role of MMC in combination ther apy. A meta-analysis, based on the available published data. failed to show any survival advantage of the MMC containing regimens (hazard ratio = 0.95 ; 95% CI 0.83-1.10). Finally, 4 eligible trials (139 patients) assessed the activity of MMC regimens as salvage therapy, 3 in combination with vindesi ne and one with cisplatin and vinblastine. The overall response rate for th e MMC-vindesine regimen was 10.5% (95% CI 1.7-19.4). In conclusion, MMC is an active drug for NSCLC but does not improve survival when combined with o ther active drugs, particularly cisplatin. Its use for salvage therapy appe ars to be associated with marginal activity only. (C) 2001 Cancer Research Campaign.