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This is a combination chemotherapy regimen consisting of three cytotoxic agents: - **5-fluorouracil (5-FU):** An antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis and repair in rapidly dividing cells. - **Semustine (also known as methyl-CCNU):** An alkylating nitrosourea compound that crosslinks DNA and RNA, leading to cell death. - **Mitomycin C:** An antitumor antibiotic that acts as an alkylating agent after metabolic activation, causing DNA crosslinking and inhibition of DNA synthesis. The combination has been studied primarily for the treatment of advanced colorectal carcinoma[2][4], with additional historical use in gastrointestinal cancers. The regimen is sometimes referred to as "MMF" (methyl-CCNU/mitomycin/fluorouracil). Clinical trials have shown no significant survival advantage over single-agent 5-FU but increased hematologic toxicity[2]. Semustine has largely fallen out of favor due to its leukemogenic potential[8].
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