Neoadjuvant topical mitomycin C chemotherapy for conjunctival and corneal intraepithelial neoplasia

Singh, Arun D.; Jacques, R; Rundle, Paul; Rennie, I G; Mudhar, Hardeep Singh; Slater, David

doi:10.1038/sj.eye.6702126

Cited by 11 publications

(9 citation statements)

References 9 publications

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“…[345] Topical chemotherapy with mitomycin-C (MMC), cidofovir, 5-fluorouracil (5-FU), or immunotherapy with interferon alpha 2b (INF α2b) has been found to be effective in the treatment of noninvasive OSSN. [67891011]…”

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confidence: 99%

“…Topical agents offer the advantage of delivering treatment not only to the affected ocular surface but also to the entire ocular surface, and thus potentially eliminating subclinical OSSN, and also diminish the risk of limbal stem cell deficiency and associated ocular surface morbidity. [678910111213141516171819202122] Although the efficacy of topical medications on OSSN is comparable (80%–100%),[678910111213141516171819202122] MMC has the highest reported rates of side effects (76%), followed by 5-FU (42%), and INF α2b is reported to have the least rates of side effects (15%). [1819] However, the cost of INF α2b ($US 175–225 per treatment) could limit its use in some patients.…”

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confidence: 99%

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Recombinant interferon alpha 2b for ocular surface squamous neoplasia: An efficient and cost-effective treatment modality in Asian Indian patients

Kaliki

Singh

Iram

et al. 2016

Indian J Ophthalmol

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Purpose:The purpose was to study the efficacy of interferon alpha 2b (INF α2b) in the treatment of ocular surface squamous neoplasia (OSSN) and analyze its cost-effectiveness in India.Study Design:This was a retrospective study of thirty patients with OSSN treated with topical INF α2b (1 MIU/cc) ± perilesional INF α2b (5 MIU/cc).Results:The tumor involved cornea (n = 9, 30%), conjunctivo-limbal-corneal surface (n = 19, 63%), or bulbar conjunctiva (n = 2, 7%). The mean basal dimension of the tumor was 16 mm. The tumors belonged to Tis (n = 6, 20%) or T3 (n = 24, 80%) based on the American Joint Committee Classification, 7th edition. In the six patients with Tis, three cycles of topical INF α2b were used for immunoprevention. In the remaining 24 patients, INF α2b was advised for immunoreduction, but served as immunotherapy with 100% tumor regression in 22 (92%) cases, and resulted in 95% immunoreduction in 2 (6%) cases. Complete tumor regression by immunotherapy (n = 22) was achieved with a mean number of three topical INF α2b cycles and two perilesional injections. All these 22 patients received three additional topical INF α2b cycles after complete tumor regression. For immunoreduction (n = 2), both patients received six cycles of topical INF α2b which was three perilesional INF α2b injections. The mean total treatment cost per patient with INF α2b was INR 9164 ($US 137). Based on maximum basal diameter of tumor at presentation, the mean total treatment cost per patient with INF α2b was INR 4866 ($US 73) for eyes with microscopic evidence of tumor residue (n = 6), INR 9607 ($US 143) for tumors ≤10 mm (n = 13), and INR 10,985 ($US 164) for tumors >10 mm (n = 11), with two patients needing additional surgical excision for complete tumor control.Conclusion:INF α2b can be used for immunoreduction, immunotherapy, or immunoprevention of OSSN. INF α2b is a cost-effective treatment modality for OSSN at an average total treatment cost of INR 9164 ($US 137) per patient.

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Recombinant interferon alpha 2b for ocular surface squamous neoplasia: An efficient and cost-effective treatment modality in Asian Indian patients

Kaliki

Singh

Iram

et al. 2016

Indian J Ophthalmol

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“…Preoperative (neoadjuvant chemotherapy) application is with the intent of decreasing tumour size prior to definitive surgery 1 11. Intraoperative application is used as a substitute for cryotherapy.…”

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Topical chemotherapy for ocular surface squamous neoplasia: current status

Sepulveda

Pe’er

Midena

et al. 2009

British Journal of Ophthalmology

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“…26 MMC may be stored at room temperature for up to 1 week and under refrigeration (41C) for up to 3 months, and still preserve its activity. [30][31][32][33][34][35][36][37][38][39][40][41] Several authors have reported the use of preoperative topical MMC in reducing the size of the epithelial tumor before excision, 42,43 or used it intraoperatively 44 (Fig. The use of topical MMC for CIN was first described by Frucht-Pery and colleagues as a sole treatment.…”

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confidence: 99%