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Marie-France Demierre, MD, FRCPC; Luc Vachon, PhD; Vincent Ho, MD; Lynda Sutton, BS; Allen Cato, MD, PhD; Brian Leyland-Jones, MD, FRCPC

Arch Dermatol. 2003;139:624-628.

Objectives  To assess the safety and tolerability of a topical gel formulation combining methotrexate and laurocapram and to obtain preliminary information on the therapeutic potential of methotrexate-laurocapram in patients with early-stage mycosis fungoides (stage IA or IB).

Design  An open-label, phase 1/2 pilot study.

Setting  Two academic referral centers.

Patients  Ten patients 18 years or older with histologically confirmed stage IA or IB mycosis fungoides.

Intervention  The gel formulation of methotrexate-laurocapram was applied to the total body surface, excluding genital, perianal areas, nipples, face, and skin under the breasts, on an every-other-day basis for 24 consecutive weeks.

Main Outcome Measures  The safety of methotrexate-laurocapram was assessed in this study by reviewing adverse events and laboratory data. Efficacy outcomes included changes in lesion condition and severity assessments, reduction in area of sample lesions, and the investigator's global evaluation.

Results  Adverse events consisted of skin reactions of mild severity. No clinically significant laboratory abnormalities were observed. Based on the investigator's global evaluation at the end of the treatment phase (week 24), 7 (78%) of 9 patients demonstrated a slight-to-moderate response to treatment with methotrexate-laurocapram. Statistical significance (P = .049) was reached for induration and pruritus, a trend (P = .10) was observed for erythema, and no change was found for scaling (P = .37).

Conclusions  These findings indicate that the topical administration of methotrexate-laurocapram is safe and in general well tolerated. This treatment may represent a new therapeutic potential for patients with mycosis fungoides.

From the Skin Oncology Program, Boston Medical Center, Boston, Mass (Dr Demierre); Cato Research Canada, St-Laurent, Quebec (Dr Vachon); Skin Care Center, Vancouver, British Columbia (Dr Ho); Durham Pharmaceuticals LLC, Durham, NC (Ms Sutton and Dr Cato); and McGill University, St Mary's Hospital, Montreal, Quebec (Dr Leyland-Jones). The authors have no relevant financial interest in this article.

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