100% Complete response rate in patients with cutaneous metastatic melanoma treated with intralesional interleukin (IL)-2, imiquimod, and topical retinoid combination therapy: Results of a case series

Vivian Y. Shi, Khiem Tran, Forum Patel, Jonathan Leventhal, Thomas Konia, Maxwell A Fung, Reason Wilken, Miki Shirakawa Garcia, Sarah D. Fitzmaurice, Jayne S Joo, Arta M Monjazeb, Barbara A Burrall, Brett King, Steve Martinez, Scott D Christensen, Emanual Michael Maverakis

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background Patients with cutaneous melanoma metastases have experienced excellent responses to intralesional interleukin (IL)-2. This has led to its recent inclusion into the US National Comprehensive Cancer Network guidelines for management of cutaneous melanoma metastases. Despite this, intralesional IL-2 has not been highlighted in the US literature nor have US physicians adopted it. Objective We sought to evaluate the effectiveness of intralesional IL-2 combined with topical imiquimod and retinoid for treatment of cutaneous metastatic melanoma. Methods A retrospective case series of 11 patients with cutaneous metastatic melanoma were treated with intralesional IL-2 combined with topical imiquimod and retinoid. Results A 100% complete local response rate with long-term follow-up (average of 24 months) was seen in all 11 patients treated with this proposed regimen. Biopsy specimens of treated sites confirmed absence of malignant cells. The most common treatment-related adverse event was rigors. Limitations Small number of patients, retrospective review of charts, and lack of a comparison group were limitations. Conclusion Intralesional IL-2 administered concomitantly with topical imiquimod and a retinoid cream is a promising therapeutic option for managing cutaneous melanoma metastases. The regimen was well tolerated and should be considered as a reasonable alternative to surgical excision.

Original languageEnglish (US)
Pages (from-to)645-654
Number of pages10
JournalJournal of the American Academy of Dermatology
Volume73
Issue number4
DOIs
StatePublished - Oct 1 2015

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imiquimod
Retinoids
Interleukin-2
Melanoma
Skin
Neoplasm Metastasis
Therapeutics
Guidelines
Physicians
Biopsy

Keywords

  • imiquimod
  • interleukin
  • intralesional
  • metastatic melanoma
  • pemphigus vulgaris
  • retinoid

ASJC Scopus subject areas

  • Dermatology

Cite this

100% Complete response rate in patients with cutaneous metastatic melanoma treated with intralesional interleukin (IL)-2, imiquimod, and topical retinoid combination therapy : Results of a case series. / Shi, Vivian Y.; Tran, Khiem; Patel, Forum; Leventhal, Jonathan; Konia, Thomas; Fung, Maxwell A; Wilken, Reason; Garcia, Miki Shirakawa; Fitzmaurice, Sarah D.; Joo, Jayne S; Monjazeb, Arta M; Burrall, Barbara A; King, Brett; Martinez, Steve; Christensen, Scott D; Maverakis, Emanual Michael.

In: Journal of the American Academy of Dermatology, Vol. 73, No. 4, 01.10.2015, p. 645-654.

Research output: Contribution to journalArticle

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title = "100{\%} Complete response rate in patients with cutaneous metastatic melanoma treated with intralesional interleukin (IL)-2, imiquimod, and topical retinoid combination therapy: Results of a case series",
abstract = "Background Patients with cutaneous melanoma metastases have experienced excellent responses to intralesional interleukin (IL)-2. This has led to its recent inclusion into the US National Comprehensive Cancer Network guidelines for management of cutaneous melanoma metastases. Despite this, intralesional IL-2 has not been highlighted in the US literature nor have US physicians adopted it. Objective We sought to evaluate the effectiveness of intralesional IL-2 combined with topical imiquimod and retinoid for treatment of cutaneous metastatic melanoma. Methods A retrospective case series of 11 patients with cutaneous metastatic melanoma were treated with intralesional IL-2 combined with topical imiquimod and retinoid. Results A 100{\%} complete local response rate with long-term follow-up (average of 24 months) was seen in all 11 patients treated with this proposed regimen. Biopsy specimens of treated sites confirmed absence of malignant cells. The most common treatment-related adverse event was rigors. Limitations Small number of patients, retrospective review of charts, and lack of a comparison group were limitations. Conclusion Intralesional IL-2 administered concomitantly with topical imiquimod and a retinoid cream is a promising therapeutic option for managing cutaneous melanoma metastases. The regimen was well tolerated and should be considered as a reasonable alternative to surgical excision.",
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T1 - 100% Complete response rate in patients with cutaneous metastatic melanoma treated with intralesional interleukin (IL)-2, imiquimod, and topical retinoid combination therapy

T2 - Results of a case series

AU - Shi, Vivian Y.

AU - Tran, Khiem

AU - Patel, Forum

AU - Leventhal, Jonathan

AU - Konia, Thomas

AU - Fung, Maxwell A

AU - Wilken, Reason

AU - Garcia, Miki Shirakawa

AU - Fitzmaurice, Sarah D.

AU - Joo, Jayne S

AU - Monjazeb, Arta M

AU - Burrall, Barbara A

AU - King, Brett

AU - Martinez, Steve

AU - Christensen, Scott D

AU - Maverakis, Emanual Michael

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Y1 - 2015/10/1

N2 - Background Patients with cutaneous melanoma metastases have experienced excellent responses to intralesional interleukin (IL)-2. This has led to its recent inclusion into the US National Comprehensive Cancer Network guidelines for management of cutaneous melanoma metastases. Despite this, intralesional IL-2 has not been highlighted in the US literature nor have US physicians adopted it. Objective We sought to evaluate the effectiveness of intralesional IL-2 combined with topical imiquimod and retinoid for treatment of cutaneous metastatic melanoma. Methods A retrospective case series of 11 patients with cutaneous metastatic melanoma were treated with intralesional IL-2 combined with topical imiquimod and retinoid. Results A 100% complete local response rate with long-term follow-up (average of 24 months) was seen in all 11 patients treated with this proposed regimen. Biopsy specimens of treated sites confirmed absence of malignant cells. The most common treatment-related adverse event was rigors. Limitations Small number of patients, retrospective review of charts, and lack of a comparison group were limitations. Conclusion Intralesional IL-2 administered concomitantly with topical imiquimod and a retinoid cream is a promising therapeutic option for managing cutaneous melanoma metastases. The regimen was well tolerated and should be considered as a reasonable alternative to surgical excision.

AB - Background Patients with cutaneous melanoma metastases have experienced excellent responses to intralesional interleukin (IL)-2. This has led to its recent inclusion into the US National Comprehensive Cancer Network guidelines for management of cutaneous melanoma metastases. Despite this, intralesional IL-2 has not been highlighted in the US literature nor have US physicians adopted it. Objective We sought to evaluate the effectiveness of intralesional IL-2 combined with topical imiquimod and retinoid for treatment of cutaneous metastatic melanoma. Methods A retrospective case series of 11 patients with cutaneous metastatic melanoma were treated with intralesional IL-2 combined with topical imiquimod and retinoid. Results A 100% complete local response rate with long-term follow-up (average of 24 months) was seen in all 11 patients treated with this proposed regimen. Biopsy specimens of treated sites confirmed absence of malignant cells. The most common treatment-related adverse event was rigors. Limitations Small number of patients, retrospective review of charts, and lack of a comparison group were limitations. Conclusion Intralesional IL-2 administered concomitantly with topical imiquimod and a retinoid cream is a promising therapeutic option for managing cutaneous melanoma metastases. The regimen was well tolerated and should be considered as a reasonable alternative to surgical excision.

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