<i>In lieu</i> of penectomy: complete resolution of penile melanoma <i>in situ</i> with topical imiquimod and tretinoin

O’Hern, Keegan; Chambers, Meagan; Ryan, Chenin; Chapman, Michael

doi:10.1111/ijd.15261

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…[ 106 ] (2020) CR 1 1 80 LM: forehead H Imiquimod 5% once/d 6 t/w for 6 w NR Complete (C) 9 m 0 (C) O’Hern et al . [ 107 ] (2020) CR 1 1 69 MIS: penis H Tretinoin 0.1% cream once/d 7 t/w for 2 weeks+ imiquimod 5% cream 5 t/w for 12 w NR Complete (C) 20 m 0 (C) Lobo and Templeman . [ 108 ] (2020) CR 1 1 88 LM: nose H Imiquimod 5% once/d 6 t/w for 12 w NR Complete (C) 12 m 0 (C) Chambers et al .…”

Section: Resultsmentioning

confidence: 99%

“…In ten studies [ 60 , 69 , 86 , 95 , 96 , 99 , 107 , 109 , 114 , 117 ], topical retinoids (tazarotene, tretinoin) were added to the topical treatment with imiquimod with different modalities (before/after/at the same time of the treatment or only in case of insufficient inflammatory response). In one case [ 77 ], the neoadjuvant therapy with imiquimod only was compared to neoadjuvant therapy with imiquimod + tazarotene.…”

Section: Resultsmentioning

confidence: 99%

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Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Vaienti,

Calzari,

Nazzaro

2023

Dermatol Ther (Heidelb)

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Introduction The classical management of melanoma is surgery, but this can be challenging because of several factors, such as age, body area, lesion size, among others. Topical imiquimod may be a therapeutic option for the treatment of melanoma in situ and lentigo maligna melanoma due to its efficacy, tolerability, and non-invasiveness. The purpose of this systematic review is to assemble current evidence on the treatment of non-metastatic melanoma with topical imiquimod. Methods The PubMed/MEDLINE and Cochrane Library databases were searched as the primary sources using the main search terms “imiquimod” combined with “lentigo maligna” and “melanoma” with the command “AND.” Articles were identified, screened, and extracted for relevant data, following the PRISMA guidelines. Results A total of 87 studies covering 1803 lesions treated with imiquimod cream were identified and included in this sytematic review. Forty-nine studies were case reports, 16 were retrospective analyses, 3 were open label trials, six were case series; one study was a controlled randomized trial, one was a randomized trial, and one was a single-arm phase III trial. Because of the high number of low-evidence studies, the overall risk of bias resulted high. In 55 studies, imiquimod 5% was used in monotherapy as the primary treatment; only in one study was imiquimod 3.75% introduced. In most cases, the topical treatment was applied once daily, with the exception of nine cases where an increased daily dosage was prescribed. The total duration of the treatment regimen was extremely variable and depended on body area and tolerability, with differences among patients of the same study. In six studies, imiquimod was used as neoadjuvant therapy before the surgical excision, and in 11 studies it was used after surgery as complementary or adjuvant therapy. In total, 1133 of the 1803 (62.8%) lesions were reported to be cleared after the treatment, taking into account that not all of the patients completed the treatment. Of these 1133 lesions, histological clearance was achieved in 645 (56.9%) lesions and clinical clearance only was achieved in 490 (43.2%) lesions; relapse occurred in 107 lesions. Conclusions The heterogeneity of the studies included in this systematic review precludes the drawing of any relevant conclusions regarding the application of imiquimod. Its efficacy in melanoma in situ and lentigo maligna melanoma has been demonstrated, but further evidence from controlled studies concerning the modalities is missing.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Vaienti,

Calzari,

Nazzaro

2023

Dermatol Ther (Heidelb)

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“…Imiquimod also upregulates the expression of the opioid growth factor receptor, increasing MET's antitumor effect [225]. This synthetic immune response modifier has been successfully applied in melanoma treatment [226][227][228][229][230]. MET did not affect adenylate cyclase activity in AB16 melanoma cells [231].…”

Section: Enkephalinmentioning

confidence: 99%

Involvement of the Opioid Peptide Family in Cancer Progression

2023

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Peptides mediate cancer progression favoring the mitogenesis, migration, and invasion of tumor cells, promoting metastasis and anti-apoptotic mechanisms, and facilitating angiogenesis/lymphangiogenesis. Tumor cells overexpress peptide receptors, crucial targets for developing specific treatments against cancer cells using peptide receptor antagonists and promoting apoptosis in tumor cells. Opioids exert an antitumoral effect, whereas others promote tumor growth and metastasis. This review updates the findings regarding the involvement of opioid peptides (enkephalins, endorphins, and dynorphins) in cancer development. Anticancer therapeutic strategies targeting the opioid peptidergic system and the main research lines to be developed regarding the topic reviewed are suggested. There is much to investigate about opioid peptides and cancer: basic information is scarce, incomplete, or absent in many tumors. This knowledge is crucial since promising anticancer strategies could be developed alone or in combination therapies with chemotherapy/radiotherapy.

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“…Although most of the large series and case reports are patients with LM, especially in the facial region, it is also used for all types of MIS, especially in difficult locations where surgery is complex. This is the case of acrolentiginous MIS [ 31 ] or MIS in genital regions, the penis and vulva, with or without involvement of the urethra [ 32 , 33 , 34 , 35 , 36 ].…”

Section: Immunotherapy In Melanoma In Situmentioning

confidence: 99%

Topical and Intralesional Immunotherapy for Melanoma In Situ: A Review

Martínez-Fernández,

González-Sixto,

Espasandín-Arias

et al. 2023

Cancers

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The incidence of in situ melanoma (MIS) has increased over the last decades. The mainstay of treatment for MIS, including lentigo maligna (LM), is complete surgical excision with clear margins (0.5 to 1.0 cm). Nevertheless, MIS lesions often affect elderly patients with comorbidities and involve large lesions in cosmetically sensitive areas, which means surgery is not always appropriate. Non-surgical treatments have a role in these cases, and include radiotherapy, cryosurgery, immunotherapy, laser therapy, and other topical medications. This study aims to review the applications of immunotherapy in MIS, either in monotherapy or in combination with other therapeutic alternatives. The main forms of immunotherapy used are imiquimod and, to a lesser extent, intralesional interferon-α (IL-INF-α) and ingenol mebutate (IM). IL-INF-α and IM have not been studied as extensively as imiquimod, whose results in real-life practice are encouraging. The clearance and recurrence rates reported in MIS treated with imiquimod as monotherapy, or as an adjuvant after surgery with affected or narrow margins, make imiquimod a reliable therapeutic alternative in selected cases. Also, its use as a neoadjuvant therapy before surgery was shown to reduce the final surgical defect size required to confirm negative histologic margins. In conclusion, local immunotherapy is frequently used in clinical practice and experience confirms it to be an excellent option for certain patients.

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In lieu of penectomy: complete resolution of penile melanoma in situ with topical imiquimod and tretinoin

Cited by 5 publications

References 4 publications

Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Topical Treatment of Melanoma In Situ, Lentigo Maligna, and Lentigo Maligna Melanoma with Imiquimod Cream: A Systematic Review of the Literature

Involvement of the Opioid Peptide Family in Cancer Progression

Topical and Intralesional Immunotherapy for Melanoma In Situ: A Review

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