Extramammary Paget's disease medical therapy: Difference between revisions

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__NOTOC__
{{Extramammary Paget's disease}}
{{Extramammary Paget's disease}}
{{CMG}}
{{CMG}}


==Overview==
==Overview==
[[Chemotherapy]] with either [[5-fluorouracil]], [[imiquimod]] cream, or the combination of [[paclitaxel]] and [[trastuzumab]] may be helpful in the treatment of extramammary Paget's disease.


==Medical Therapy==
The following [[Medical therapy template|medical therapies]] have been studied for the treatment of extramammary Paget's disease:<ref name="pmid19691751">{{cite journal| author=Takahagi S, Noda H, Kamegashira A, Madokoro N, Hori I, Shindo H et al.| title=Metastatic extramammary Paget's disease treated with paclitaxel and trastuzumab combination chemotherapy. | journal=J Dermatol | year= 2009 | volume= 36 | issue= 8 | pages= 457-61 | pmid=19691751 | doi=10.1111/j.1346-8138.2009.00676.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19691751  }} </ref><ref name="pmid19840203">{{cite journal| author=Sendagorta E, Herranz P, Feito M, Ramírez P, Floristán U, Feltes R et al.| title=Successful treatment of three cases of primary extramammary Paget's disease of the vulva with Imiquimod--proposal of a therapeutic schedule. | journal=J Eur Acad Dermatol Venereol | year= 2010 | volume= 24 | issue= 4 | pages= 490-2 | pmid=19840203 | doi=10.1111/j.1468-3083.2009.03451.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19840203  }} </ref><ref name="pmid25259595">{{cite journal| author=Marchitelli C, Peremateu MS, Sluga MC, Berasategui MT, Lopez DG, Wernicke A et al.| title=Treatment of primary vulvar paget disease with 5% imiquimod cream. | journal=J Low Genit Tract Dis | year= 2014 | volume= 18 | issue= 4 | pages= 347-50 | pmid=25259595 | doi=10.1097/LGT.0000000000000053 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25259595  }} </ref><ref name="pmid19862365">{{cite journal| author=Beleznay KM, Levesque MA, Gill S| title=Response to 5-fluorouracil in metastatic extramammary Paget disease of the scrotum presenting as pancytopenia and back pain. | journal=Curr Oncol | year= 2009 | volume= 16 | issue= 5 | pages= 81-3 | pmid=19862365 | doi= | pmc=PMC2768510 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19862365  }} </ref>
*[[5-fluorouracil]]
*[[Imiquimod]]
*Combination of [[paclitaxel]] and [[trastuzumab]]
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center"
| valign="top" |
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Medication}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Mechanism of action}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Dosage}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
:Imiquimod
| style="padding: 5px 5px; background: #F5F5F5;" |
*These agents modulate key factors of the immune system
*Imiquimod is a immune response modifier with an unknown mechanism of action
| style="padding: 5px 5px; background: #F5F5F5;" |
*Imiquimod 5% cream is applied 3 times weekly for 16 weeks.
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Fluorouracil
| style="padding: 5px 5px; background: #F5F5F5;" |
*These agents inhibit cell growth and proliferation
*Fluorouracil interferes with DNA synthesis by blocking methylation of deoxyuridylic acid via inhibition of thymidylate synthetase and, eventually, cell proliferation.
| style="padding: 5px 5px; background: #F5F5F5;" |
*It is used topically
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Paclitaxel
| style="padding: 5px 5px; background: #F5F5F5;" |
*Paclitaxel's mechanism of action involves interference with the normal breakdown of microtubules during cell division
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Trastuzumab
| style="padding: 5px 5px; background: #F5F5F5;" |
*Trastuzumab is a recombinant monoclonal antibody against human epidermal growth factor receptor 2 (HER2). It is effective when tumor cells overexpress HER2 protein.
| style="padding: 5px 5px; background: #F5F5F5;" |
|-
|}
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 13:55, 10 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Chemotherapy with either 5-fluorouracil, imiquimod cream, or the combination of paclitaxel and trastuzumab may be helpful in the treatment of extramammary Paget's disease.

Medical Therapy

The following medical therapies have been studied for the treatment of extramammary Paget's disease:[1][2][3][4]

Medication Mechanism of action Dosage
Imiquimod
  • These agents modulate key factors of the immune system
  • Imiquimod is a immune response modifier with an unknown mechanism of action
  • Imiquimod 5% cream is applied 3 times weekly for 16 weeks.
Fluorouracil
  • These agents inhibit cell growth and proliferation
  • Fluorouracil interferes with DNA synthesis by blocking methylation of deoxyuridylic acid via inhibition of thymidylate synthetase and, eventually, cell proliferation.
  • It is used topically
Paclitaxel
  • Paclitaxel's mechanism of action involves interference with the normal breakdown of microtubules during cell division
Trastuzumab
  • Trastuzumab is a recombinant monoclonal antibody against human epidermal growth factor receptor 2 (HER2). It is effective when tumor cells overexpress HER2 protein.

References

  1. ↑ Takahagi S, Noda H, Kamegashira A, Madokoro N, Hori I, Shindo H; et al. (2009). "Metastatic extramammary Paget's disease treated with paclitaxel and trastuzumab combination chemotherapy". J Dermatol. 36 (8): 457–61. doi:10.1111/j.1346-8138.2009.00676.x. PMID 19691751.
  2. ↑ Sendagorta E, Herranz P, Feito M, Ramírez P, Floristán U, Feltes R; et al. (2010). "Successful treatment of three cases of primary extramammary Paget's disease of the vulva with Imiquimod--proposal of a therapeutic schedule". J Eur Acad Dermatol Venereol. 24 (4): 490–2. doi:10.1111/j.1468-3083.2009.03451.x. PMID 19840203.
  3. ↑ Marchitelli C, Peremateu MS, Sluga MC, Berasategui MT, Lopez DG, Wernicke A; et al. (2014). "Treatment of primary vulvar paget disease with 5% imiquimod cream". J Low Genit Tract Dis. 18 (4): 347–50. doi:10.1097/LGT.0000000000000053. PMID 25259595.
  4. ↑ Beleznay KM, Levesque MA, Gill S (2009). "Response to 5-fluorouracil in metastatic extramammary Paget disease of the scrotum presenting as pancytopenia and back pain". Curr Oncol. 16 (5): 81–3. PMC 2768510. PMID 19862365.


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