Any long term skin mets survivors?

[Delaney]

Just wondering if anyone survived long term with skin mets. Mine have come back despite being on tyverb/xeloda + herceptin. meeting the oncologist next week to decide what to do next. It came back as a blotchy rash on my arm and a spot near my ankle! Really wanted to get to be NED , would so like a break from all this crap. If anyone has any encouraging news I would really appreciate it.

[ElaineM]

Some people at ibcsupport.org have used Aldara (Immiquimod) cream for breast cancer skin mets.
It was developed for basel cell carcinoma and warts, but it is being used for other types of cancers in the skin, including breast cancer.
www.aldara.com.

[ElaineM]

This was posted on www.ibcsupport.org.
http://depts.washington.edu/tumorvac...ntific_131.php
It is a clinical trial using Abraxane and Immiquimod cream (Aldara)for skin mets.

[Jackie07]

Here's a case reported in Japan where a patient's skin mets was successfully treated:

Gan To Kagaku Ryoho. 2009 Nov;36(12):2484-6.
[A case of advanced breast cancer with skin ulceration successfully treated with paclitaxel and toremifene therapy]

[Article in Japanese]
Sakurai K, Fujisaki S, Matsuo S, Ogura M, Enomoto K, Kitajima A, Tani M, Amano S, Shiono M.
Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine.
Abstract

We report a case of advanced breast cancer with skin ulceration and bleeding (T4bN3bM0, Stage IIIC) achieving a significant improvement of QOL by paclitaxel (PTX) and toremifene (TOR) therapy. The patient was a 31-year-old woman who had ulcerative breast lump with skin ulcer. A core needle biopsy for breast tumor led to a diagnosis of an invasive ductal carcinoma positive for estrogen receptor and progesterone receptor, and negative for HER2/neu protein expression. She received 4 courses of tri-weekly CEF (C: 500 mg, E: 60 mg, F: 500 mg/m2/tri-weekly) and 4 courses of weekly PTX (80 mg/m2) with TOR (120 mg/day). The bleeding from the tumor disappeared after CEF chemotherapy. The response for breast tumor after PTX and TOR therapy was evaluated as partial response, and the infraclavicular, subpectoral, and interpectoral lymph nodes metastasis disappeared. Muscle-preserving radical mastectomy (Bt+Ax: Auchincloss) without skin transplantation were performed. She had no recurrence during one year after operation. PTX and TOR therapy were effective for advanced breast tumor, and can improve patient QOL and the clinical outcomes in Stage IIIC advanced breast cancer.

PMID: 20037463 [PubMed - indexed for MEDLINE]

[Jackie07]

Another article:

Gan To Kagaku Ryoho. 2010 Apr;37(4):649-53.
[More effective positioning of capecitabine for advanced and metastatic breast cancer]

[Article in Japanese]
Tsuyuki S, Kawaguchisakita N, Tsubota Y, Ukikusa M, Kohno Y.
Department of Breast and General Surgery, Osaka Red Cross Hospital.
Abstract

We investigated 30 patients with advanced and metastatic breast cancer who underwent capecitabine therapy in our department from July, 2004 to April, 2009. Patients' backgrounds: 35-82 years of age (median, 62 years of age). Performance status (PS): 0 approximately 1 in 21 cases, PS:2 in 7 cases and PS:3 in 2 cases. 63% of patients were positive ER and/or PgR, and 33. 3% were positive HER2. Of these patients, 17 had bone, 15 lymph node, 13 lung, 7 liver, and 4 skin metastasis. The capecitabine response in these patients was evaluated as follows: partial response (PR) in 9, stable disease (SD)in 6, long SD in 4, and progressive disease(PD)in 11, indicating a response rate(RR)of 30% and a clinical benefit rate (CBR) of 43. 3%. In comparison with after third-line treatment, capecitabine proved more effective as first or second-line treatment. Interestingly, the capecitabine response in HER2 negative-expressing patients, especially in HR(+)/HER2(-)subgroup, was significantly better than that in HER2-over-expressing patients. The soft tissue lesions(primary tumor and metastasis of skin and lymph nodes)showed a significantly better response to capecitabine treatment than other metastases such as lung, liver and bone. There was a significant difference in the response rate between soft tissue metastasis (lymph nodes, skin and primary tumor)and other types of metastasis (lung, liver, and bone). Finally, it was suggested that use of capecitabine in upfront line for HER2-negative expressing cases or soft tissue metastatic cases contributed to the prolongation of time to treatment failure(TTF)and overall survival.

PMID: 20414020 [PubMed - indexed for MEDLINE

[Jackie07]

Gan To Kagaku Ryoho. 2008 Nov;35(12):2222-4.
[Recurrence of skin and lymph nodes from asynchronous breast cancer successfully treated with paclitaxel and toremifene therapy--a case report]

[Article in Japanese]
Sakurai K, Enomoto K, Tani M, Kitajima A, Amano S, Shiono M.
Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.
Abstract

We report a case of recurrence of skin and lymph nodes from asynchronous breast cancer achieving a significant improvement of QOL by toremifene and paclitaxel therapy. The patient was a 49-year-old woman who received both sides of muscle-preserving radical mastectomy (Bt+Ax: Auchincloss) had a skin redness of her left breast. Aspiration biopsy cytology for the skin led to a diagnosis of Class V. Skin biopsy for the part of the redness was performed. The pathological diagnosis was an invasive ductal carcinoma, negative for estrogen receptor and positive for progesteron receptor, and negative for HER2/neu protein expression. Ultrasonography showed the subpectral and the inflaclavicular lymph nodes swelling and the skin metastasis. Enhancement CT showed no metastasis of brain, lung, liver, and other organs. Although she had already received 6 cycles of tri-weekly FEC (C: 500 mg, E 60 mg, F: 500 mg/m2) after previous operation, we performed 7 cycles of weekly paclitaxel (80 mg/m2) with toremifene (120 mg/day). The response for the lesion of lymph nodes metastasis after paclitaxel and toremifene therapy was evaluated as a complete response. The subpectoral and the inflaclavicular lymph nodes metastasis disappeared. However, the skin redness of her left breast was still remained. She had received a radiation therapy (30 Gy) for skin metastasis. After radiation therapy, we performed a skin biopsy for the part of the redness. The pathological diagnosis was no carcinoma of skin. She had no recurrence during the two years after the treatment. Paclitaxel and toremifene therapy was effective for a recurrent breast tumor and could improve patient's QOL and the clinical outcomes.

PMID: 19106577 [PubMed - indexed for MEDLINE]

[Trish]

Hi Delaney
Sorry I can't help with skin mets -I'm a liver specialist. I'm so glad others are monitoring the literature and so generously sharing their knowledge with us. I love reading your posts and look forward to reading many more as you seem to be a long term skin met survivor. May you stay one for a long time!
Trish

[Delaney]

Thanks all for your response. I am due to have a CT scan soon and then meet with the oncologist to see if medication needs to be changed. Jackie, thanks for those study cases, I had paclitaxel last year. I will mention both paclitaxel and toremifene at my next consultation.

[ElaineM]

There seems to be more discussion about skin mets lately, so I decided to cross link the three discussions, so people will have alot of information in one place.
http://her2support.org/vbulletin/sho...d=1#post238900