A case report of imiquimod topical therapy as treatment for cutaneous metastasis of breast cancer

Cutaneous metastasis of breast cancer carries a poor prognosis, invokes a poor quality of life, and increases mortality by raising one’s risk of bleeding and infection. Currently, options for treatment are systemic chemotherapy, surgical resection and radiation. These treatments are invasive and can have toxic side effects. A 50-year-old African-American woman with stage IV breast cancer with cutaneous metastasis to the left anterior chest and left supraclavicular area was successfully treated with topical imiquimod. She experienced improvement in appearance and symptoms within several months of starting treatment, resulting in near resolution of her cutaneous metastasis. Imiquimod is currently approved for several cutaneous conditions and has the potential to treat cutaneous metastasis of breast cancer.

1. Hengge, UR, Roth, S, Tannapfel, A. Topical imiquimod to treat recurrent breast cancer. Breast Cancer Res Treat 2005; 94(1): 93–94.
Google Scholar | Crossref | Medline2. Henriques, L, Palumbo, M, Guay, MP, et al. Imiquimod in the treatment of breast cancer skin metastasis. J Clin Oncol 2014; 32(8): e22–e25.
Google Scholar | Crossref | Medline3. Wagstaff, AJ, Perry, CM. Topical imiquimod: a review of its use in the management of anogenital warts, actinic keratoses, basal cell carcinoma and other skin lesions. Drugs 2007; 67(15): 2187–2210.
Google Scholar | Crossref | Medline4. Bubna, AK. Imiquimod - its role in the treatment of cutaneous malignancies. Indian J Pharmacol 2015; 47(4): 354–359.
Google Scholar | Crossref | Medline5. Stanley, MA. Imiquimod and the imidazoquinolones: mechanism of action and therapeutic potential. Clin Exp Dermatol 2002; 27(7): 571–577.
Google Scholar | Crossref | Medline6. Navi, D, Huntley, A. Imiquimod 5 percent cream and the treatment of cutaneous malignancy. Dermatol Online J 2004; 10(1): 4.
Google Scholar | Crossref | Medline7. Krishnasamy, SR, Almazan, TH, Suero-Abreu, GA, et al. Successful treatment of cutaneous metastatic breast cancer with topical treatments that potentially synergize with systemic therapy: a case series. JAAD Case Rep 2018; 4(7): 711–715.
Google Scholar | Crossref | Medline8. Dewan, MZ, Vanpouille-Box, C, Kawashima, N, et al. Synergy of topical toll-like receptor 7 agonist with radiation and low-dose cyclophosphamide in a mouse model of cutaneous breast cancer. Clin Cancer Res 2012; 18(24): 6668–6678.
Google Scholar | Crossref | Medline9. Adams, S, Kozhaya, L, Martiniuk, F, et al. Topical TLR7 agonist imiquimod can induce immune-mediated rejection of skin metastases in patients with breast cancer. Clin Cancer Res 2012; 18(24): 6748–6757.
Google Scholar | Crossref | Medline10. Salazar, LG, Lu, H, Reichow, JL, et al. Topical imiquimod plus nab-paclitaxel for breast cancer cutaneous metastases: a phase 2 clinical trial. JAMA Oncol 2017; 3(7): 969–973.
Google Scholar | Crossref | Medline11. Steinmann, A, Funk, JO, Schuler, G, et al. Topical imiquimod treatment of a cutaneous melanomametastasis. J Am Acad Dermatol 2000; 43(3): 555–556.
Google Scholar | Medline12. Ray, CM, Kluk, M, Grin, CM, et al. Successful treatment of malignant melanoma in situ with topical 5% imiquimod cream. Int J Dermatol 2005; 44(5): 428–434.
Google Scholar | Crossref | Medline13. Rozenblit, M, Hendrickx, W, Heguy, A, et al. Transcriptomic profiles conducive to immune-mediated tumor rejection in human breast cancer skin metastases treated with Imiquimod. Sci Rep 2019; 9(1): 8572.
Google Scholar | Crossref | Medline

Comments (0)

No login
gif