Miltefosine as a topical treatment for cutaneous metastases in breast carcinoma

• Published in: Cancer chemotherapy and pharmacology 1999, Vol.44, p.S29-S30
• Main Authors: CLIVE, S, GARDINER, J, LEONARD, R. C. F
• Format: Article
• Language: English
• Subjects: Administration, Topical; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms, Male - drug therapy; Breast Neoplasms, Male - pathology; Carcinoma - drug therapy; Carcinoma - secondary; Chemotherapy; Female; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Phosphorylcholine - analogs & derivatives; Phosphorylcholine - therapeutic use; Skin Neoplasms - drug therapy; Skin Neoplasms - secondary; Treatment Outcome
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s002800051114

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. 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. 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. Miltefosine, either used alone or in conjunction with other therapies for distant metastases, is an effective and tolerable local treatment for cutaneous breast cancer.