Mitomycin C
The chemotherapy given with radiation to cure anal cancer without surgery, used as a bladder instillation after tumour resection, and since 2020-25 in gel form for upper-tract and recurrent bladder cancers.
Approved 1974 (gastric, pancreatic). Anal SCC chemoradiation (Nigro, ACT II), intravesical single instillation after TURBT for NMIBC, hyperthermic intravesical and HIPEC use (appendiceal/PMP), ophthalmic antifibrotic. Mitomycin gel (Jelmyto, 2020) for low-grade upper-tract urothelial carcinoma and intravesical gel (Zusduri, 2025) for recurrent low-grade intermediate-risk NMIBC. Haemolytic uraemic syndrome and pulmonary toxicity at cumulative doses.
- Medicare
- Part B (clinician-administered)
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. IV and intravesical mitomycin are generic Part B drugs. Jelmyto (pyelocalyceal) and Zusduri (intravesical, 2025) are branded, clinician-instilled products under Part B with higher coinsurance.
- Commercial insurance
- covered on label
Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens. Jelmyto and Zusduri typically require prior authorisation.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
- Notes
- Generic; intravesical mitomycin is standard after TURBT (NICE NG2). Jelmyto and Zusduri formulations are not UK-licensed.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE search: mitomycin C. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1974 | Disseminated gastric or pancreatic adenocarcinoma (with other agents) |
| US | 2020 | Low-grade upper tract urothelial carcinoma (mitomycin pyelocalyceal gel) |
| US | 2025 | Recurrent low-grade intermediate-risk NMIBC (intravesical gel) |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Mitomycin C" OR ABSTRACT:"Mitomycin C" OR TITLE:"Mutamycin" OR ABSTRACT:"Mutamycin" OR TITLE:"Jelmyto" OR ABSTRACT:"Jelmyto" OR TITLE:"Zusduri" OR ABSTRACT:"Zusduri") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Mitomycin C, not a curated reading list.
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