Deferoxamine Intradermal Delivery Patch for Treatment of a Radiation Therapy Associated Breast Wound.

Purpose: Radiation therapy is used in over 60% of cancer patients and can lead to radiation dermatitis, radiation induced fibrosis, hyperpigmentation, telangiectasias, fat necrosis, and poor wound healing. Deferoxamine (DFO) is an iron-chelating agent that has been used systemically to treat iron overload conditions and more recently been studied to treat radiation fibrosis. Through iron chelation, DFO stabilizes hypoxia inducible factor-1α, driving downstream upregulation of angiogenic factors, and reduces formation of reactive oxygen species, thereby offering a potential therapy for radiation associated chronic wounds. The purpose of this work was to describe treatment of a refractory wound following radiation treatment that had failed conventional therapy. Methods: The patient is a 71-year-old female with inflammatory breast cancer that developed a radiation related wound after mastectomy, chemotherapy, and radiation therapy. The wound did not show any signs of improvement with five months of wound care and risk factor modification. The patient was offered treatment with a topical Deferoxamine Intradermal Delivery Patch through the FDA single patient investigative new drug pathway. Results: After two weeks of treatment, the wound healed. Additionally, serum was collected at cessation of therapy and 5 weeks after, with both samples showing no significant systemically detectible level of the drug to be present. Subjectively the patient reported improvement in appearance and quality of the skin. Conclusion: Topical deferoxamine is a promising therapy for radiation wounds. Although this report is limited to a single patient experience, we believe this work is important in describing the first in-human use of topical deferoxamine to heal a radiation therapy associated wound.