The potential role of topotecan in the treatment of advanced breast cancer.

: Despite the rational use of hormonal, surgical, radiotherapeutic, and chemotherapeutic interventions, metastatic breast cancer represents a historically incurable disease and is currently one of the leading causes of cancer-related death in women. Survival rates in patients with metastatic breast cancer vary with location and type of metastasis, but virtually all will relapse. Standard cytotoxic therapies for the treatment of metastatic breast cancer remain unsatisfactory; thus, new active agents can be a valuable option for many patients. Topotecan (Hycamtin; SmithKline Beecham Pharmaceuticals, Philadelphia, PA), a topoisomerase I inhibitor, currently is being assessed in the treatment of metastatic breast cancer. Preliminary results from preclinical and phase I trials suggest topotecan is active against breast cancer. Results of ongoing phase II trials thus far suggest that topotecan may be effective in stabilizing disease and prolonging time to relapse. Further studies are needed to determine whether topotecan will prove to be a valuable new option in the treatment of metastatic breast cancer.