Miltefosine as a topical treatment for cutaneous metastases in breast carcinoma.
BACKGROUND
Recurrent cutaneous breast cancer is difficult to manage, with surgery, radiotherapy and systemic therapy all having their limitations. Miltefosine is a topical cytostatic agent which may provide an alternative approach in its treatment.


METHODS
Patients with previously treated progressive cutaneous lesions from breast cancer were treated with miltefosine on a named-patient compassionate supply basis. Miltefosine was applied topically to the skin at a dose of 2 drops/10 cm(2) skin area.


RESULTS
Twenty-five patients were treated, most of whom had been heavily pre-treated. Treatment was continued for a median of 14 weeks (range 2-164). In 7 patients grade I skin toxicities were observed, and in 4 patients grade 3 local toxicities necessitated dose adjustments. A response was seen in 9 patients (1 complete response, 2 partial responses, 6 minor responses) giving a total response rate of 36%, with stable disease in 11 patients (44%) and progressive disease in 5 (20%). Those lesions which were superficial or < 2 cm in diameter were most likely to respond.


CONCLUSIONS
Miltefosine, either used alone or in conjunction with other therapies for distant metastases, is an effective and tolerable local treatment for cutaneous breast cancer.
Clive
S
S
Department of Oncology, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, Scotland, UK.
Gardiner
J
J
Leonard
R C
RC
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018567:Breast Neoplasms, Male / Q000188:drug therapy / Q000473:pathology; D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010767:Phosphorylcholine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000556:secondary; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D010767:Phosphorylcholine; C039128:miltefosine