Mitomycin C has resulted in reduction in symptoms and fewer dilations in patients with caustic ingestions. What is the proposed mechanism for this?
In a recent review article by Hoffman RS et al., additional therapies for caustic ingestions was described including sucralfate and mitomycin C. Mitomycin C induces fibroblast apoptosis and thereby reduces scarring. Despite the reduction in symptoms and fewer dilations required in patients receiving mitomycin C versus placebo, the long term risk of malignant transformation because of mitomycin’s ability to damage DNA is unknown and therefore the authors do not recommend treatment with mitomycin C at this time. [Hoffman RS et al. Ingestion of Caustic Substances. NEJM 2020; 382: 173901748. doi: 10.1056/NEJMra1810769]