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Fluorouracil + mitomycin is a combination chemotherapy regimen consisting of the antimetabolite fluorouracil (5-FU) and the antitumor antibiotic mitomycin-C. This combination is a standard-of-care component in the definitive treatment of locally advanced anal canal cancer, typically administered concurrently with radiation therapy (chemoradiotherapy). Fluorouracil, a pyrimidine analog, exerts its cytotoxic effect primarily by inhibiting thymidylate synthase, which disrupts DNA synthesis. Mitomycin-C acts as a bioreductive alkylating agent that induces DNA cross-linking, leading to cell cycle arrest and apoptosis. In the clinical trial context associated with Centre Francois Baclesse, this combination is evaluated alongside Simultaneously Integrated Boost Intensity-Modulated Radiation Therapy (SIB-IMRT) to optimize locoregional control and preserve anal sphincter function while reducing the non-hematological toxicities associated with conventional radiotherapy.
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