Combined effect of topical arsenic trioxide and radiation therapy on skin-infiltrating lesions of breast cancer???a pilot study

Abstract

It has been reported that arsenic trioxide (As2O3) is an apoptosis inducer and radiation sensitizer for various cancer cell lines. In this study of breast cancer patients, we examined the combined effect of topical As2O3 and radiation therapy on fungating and/or skin-infiltrating lesions of breast cancer. The dermatological, gastrointestinal, hematological, renal and hepatic toxicities of the treatment were also monitored. As2O3 gel (0.05%) was applied to tumor lesions 1 h prior to delivery of each fraction, with the gel removed about 5 min before the irradiation. Superficial radiation was delivered using an electron beam from a linear accelerator. Every week, the tumor lesions were photographed to evaluate effectiveness, and blood was sampled to monitor changes in hemogram and biochemical profile. Seven breast cancer patients with cutaneous metastasis were enrolled in this study. In terms of tumor, the rates for complete, partial response and stable disease were 42.9 (three of seven), 42.9 (three of seven) and 14.3% (one of seven), respectively. The skin pain, assessed by a visual analog scale, and secretion from all of the seven superficial and fungating wounds decreased markedly after treatment. Significant bone marrow suppression or granulocytosis was not noted. Further, changes in renal and hepatic function were also not significant. It seems reasonable to conclude that As2O3 may be an effective and safe radiosensitizer for palliative radiotherapy for skin-infiltrating lesions of breast cancer.

Arsenic trioxide targets MTHFD1 and SUMO-dependent nuclear de novo thymidylate biosynthesis

“…Arsenic trioxide (As 2 O 3 ) is often referred to as a double-edged sword, because it is also a drug approved by the US Food and Drug Administration that is administered in anticancer therapies, alone or in combination with other compounds (42,43). Importantly, As 2 O 3 therapy is efficacious in the treatment of acute promyelocytic leukemia (44), where it is known to affect PML-RARα (promyelocytic leukemia protein and retinoic acid receptor alpha fusion) SUMOylation (45).…”

Tumor growth inhibition of metastatic nasopharyngeal carcinoma cell lines by low dose of arsenic trioxide via alteration of cell cycle progression and induction of apoptosis

“…[24][25][26][27][28] The aggressive invasiveness and different receptor expressions in metastatic cancer cells sometimes lead to treatment failure, even though the therapeutic agents are effective in cancer cells from the primary sites. 29 Furthermore, although the clinical toxicity of ATO includes anorexia, peripheral numbness, and gastrointestinal problems, all of which are well tolerated in most patients with good performance, 30 these adverse effects and the potential of carcinogen may offset the efficacy and limit the application of ATO in the treatment of solid tumors. 31,32 Patients with metastatic NPC usually experience comorbidity, poor medical outcomes, and complications from previous chemoradiotherapy upon initiation of palliative therapy, so serious ATO-related complications may be inevitable.…”

Desmoplastic trichoepithelioma: A clinicopathological study of three cases and a review of the literature

“…Although the most common sites of cutaneous metastatic breast cancer are the chest and abdomen, metastasis can less commonly be discovered on the scalp, face, neck, upper extremities, abdomen and back. Patients may present with rapidly-growing, asymptomatic, firm, scar-like nodules or tumors on the face, which may mimic DTE (30). Any rapidly-growing lesions should warrant careful consideration of the possibility of metastasis.…”