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Methotrexate + mitomycin + mitoxantrone (commonly known as the MMM regimen) is a combination chemotherapy protocol used primarily for the treatment of advanced or metastatic breast cancer. The regimen consists of three cytotoxic agents: - Methotrexate, an antimetabolite that inhibits dihydrofolate reductase, interfering with DNA synthesis and cell replication. - Mitomycin (specifically, mitomycin C), an alkylating agent that cross-links DNA and inhibits DNA synthesis. - Mitoxantrone, an anthracenedione that intercalates into DNA and inhibits topoisomerase II, leading to breaks in DNA strands. The combination targets rapidly dividing cancer cells through multiple mechanisms of action. Administration is intravenous and typically given in cycles every 42 days for up to six cycles or until disease progression or unacceptable toxicity occurs[1][2][4]. The regimen has demonstrated efficacy comparable to other standard regimens such as CMF (cyclophosphamide, methotrexate, fluorouracil) in clinical trials for advanced breast carcinoma[1]. It has also been studied in malignant pleural mesothelioma[3].
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