Topical treatment of cutaneous metastases of malignant melanoma using combined imiquimod and 5-fluorouracil

Florin, V.; Desmedt, E.; Vercambre-Darras, S.; Mortier, Laurent

doi:10.1007/s10637-011-9717-2

Cited by 56 publications

(38 citation statements)

References 19 publications

(19 reference statements)

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“…Although cutaneous metastases have a poor prognosis, its treatment may be beneficial for palliation. Several reports have described some benefit from the off‐label use of topical imiquimod as alternative to surgery and as adjunctive modality after surgical excision, alone or in combination with other systemic treatments, in the management of cutaneous metastases from different origins including melanoma and breast and renal cancer …”

Section: Off‐label Uses Of Imiquimod In Cutaneous Disordersmentioning

confidence: 99%

Imiquimod in dermatology: an overview

2016

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Imiquimod is an immune response modifier commercially available as a 3.75 and 5% cream. Topical imiquimod stimulates the innate and adaptive immune responses and induces cytokine production. This allows its use for the treatment of a wide variety of benign and malignant skin conditions due to its potential antiviral, antitumor, and immunoregulatory effects. Currently, topical imiquimod is US Food and Drug Administration (FDA)-approved for the treatment of anogenital warts, actinic keratosis, and superficial basal cell carcinomas. However, it has also shown a beneficial effect in the treatment of many other skin disorders. In this review, we describe existing evidence on the mechanism of action of topical imiquimod, its FDA-approved indications, off-label uses, and side effects.

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Section: Off‐label Uses Of Imiquimod In Cutaneous Disordersmentioning

confidence: 99%

Imiquimod in dermatology: an overview

2016

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“…[128][129][130][131][132] Other studies have shown that imiquimod used in combination with another local therapy can provide high rates of durable response in patients with locally metastatic melanoma. 130,[133][134][135][136][137][138][139] Topical immunotherapy using diphencyprone (DPCP), also known as diphenylcyclopropenone, has been studied in patients with in-transit melanoma, either alone or in combination with other concomitant therapies. As with topical imiquimod, supporting evidence for this approach comes primarily from case studies reporting remarkable responses in some patients.…”

mentioning

confidence: 99%

Melanoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology

Coit¹,

Thompson²,

Algazi³

et al. 2016

J Natl Compr Canc Netw

218

167

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OverviewIn 2016, an estimated 76,380 patients will be diagnosed with and approximately 10,130 patients will die of melanoma in the United States.1 However, these figures for new cases may represent a substantial underestimate, as many superficial and in situ melanomas treated in the outpatient setting are not reported. The incidence of melanoma continues to increase dramatically, at an overall rate of 33% for men and 23% women from 2002 to 2006.2 Melanoma is increasing in men more rapidly than any other malignancy, and in women more rapidly than any other malignancy except lung cancer. AbstractThis selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Melanoma focuses on adjuvant therapy and treatment of in-transit disease, because substantial changes were made to the recommendations for the 2016 update. Depending on the stage of the disease, options for adjuvant therapy now include biochemotherapy and highdose ipilimumab. Treatment options for in-transit disease now include intralesional injection with talimogene laherparepvec (T-VEC), a new immunotherapy. These additions prompted reassessment of the data supporting older recommended treatment options for adjuvant therapy and in-transit disease, resulting in extensive revisions to the supporting discussion sections. J Natl Compr Canc Netw 2016;14(4):450-473 NCCN Categories of Evidence and ConsensusCategory 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate. Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate.All recommendations are category 2A unless otherwise noted.Clinical trials: NCCN believes that the best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged. Please NoteThe NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ® ) are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult the NCCN Guidelines ® is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network ® (NCCN ® ) makes no representation or warranties of any kind regarding their content, use, or application and disclaims any responsibility for their applications or use in any way. The full NCCN Guidelines for Melanoma are not printed in this issue of JNCCN but can be accessed online at NCCN.org.© National Comprehensive Cancer Network, Inc. 2016, All rights reserved. The NCCN Guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN. Disclosures for the NCCN Melanoma ...

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“…74 Since 2000, it has been used for advanced melanoma in various case reports and small case series. 6,75–77 The largest case series is of 5 patients treated with combination topical imiquimod/fluorouracil; a response was elicited in 44 of 45 lesions. 77 Combined treatments with IL-2 and BCG have also been reported.…”

Section: Topical Therapiesmentioning

confidence: 99%

“…6,75–77 The largest case series is of 5 patients treated with combination topical imiquimod/fluorouracil; a response was elicited in 44 of 45 lesions. 77 Combined treatments with IL-2 and BCG have also been reported. 41,57 More evidence is available for patients with lentigo maligna, including a large case reporting that more than 90% of study patients with lentigo maligna experience regression with daily or twice-daily application of an imiquimod cream.…”

Section: Topical Therapiesmentioning

confidence: 99%

Developments in Intralesional Therapy for Metastatic Melanoma

Sloot

Rashid

Sarnaik³

et al. 2016

Cancer Control

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Background Locoregional advanced melanoma poses a complex clinical challenge that requires a multidisciplinary, patient-centered approach. Numerous agents have been studied for their suitability as intralesional therapy in the past decades, but few have successfully completed phase 3 clinical trial testing. Methods The relevant medical literature was searched for articles regarding use of intralesional therapies in metastatic melanoma. Therapies with data from phase 2 or higher studies were selected for review. This review also summarizes the mechanisms of action, adverse-event profiles, and clinical data for these agents. Results Intralesional therapies demonstrate promising effects in select patients and are a valuable asset to the current treatment options in advanced melanoma. The optimal approach should be tailored to the individual patient and consists of a combination of intralesional therapies, regional perfusions, systemic immunotherapies, targeted therapies and/or surgery. Conclusions Due to relatively good local response rates and tolerable adverse-event profile, intralesional therapy may be a treatment option for patients with unresectable locally advanced or metastatic melanoma.

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Topical treatment of cutaneous metastases of malignant melanoma using combined imiquimod and 5-fluorouracil

Abstract: The imiquimod and 5-fluorouracil combination is effective. That patients did not develop new, distant lesions suggests the achievement of locoregional control, probably by the induction of antitumor immune response.

Cited by 56 publications

References 19 publications

Imiquimod in dermatology: an overview

Imiquimod in dermatology: an overview

Melanoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology

Developments in Intralesional Therapy for Metastatic Melanoma

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