Imiquimod, a topical immune response modifier, in the treatment of cutaneous metastases of malignant melanoma.
BACKGROUND
Imiquimod 5% cream (Aldara, a novel topical immune response modifier, has been approved for the topical treatment of anogenital HPV-induced warts. In addition, several studies have demonstrated antitumoral activity in solar keratoses, superficial basal cell carcinomas and Bowen's disease.


OBJECTIVE
Given the convincing therapeutic results of imiquimod when used for treating selected types of epithelial skin cancer, we became interested to study imiquimod as an adjuvant for treating cutaneous metastases of malignant melanoma.


METHODS
Three patients with multiple, i.e. more than 15, cutaneous in-transit metastases of malignant melanoma in unilateral localization on the leg were treated topically with imiquimod 5% cream.


RESULTS
Twice daily application under occlusive conditions for a period of 21-28 weeks resulted in >90% regression of cutaneous metastases in 2 patients. The third patient showed marked response only when topical imiquimod was intermittently supplemented by intralesional interleukin (IL)-2 for 2 weeks. Unwanted side effects were mild in all patients.


CONCLUSIONS
Overall, imiquimod as a single agent or in combination with intralesional IL-2 may be a promising immunomodulatory compound for the adjuvant topical treatment of patients with multiple cutaneous metastases of malignant melanoma.
Bong
Anne B
AB
Department of Dermatology and Venereology, Otto von Guericke University, Magdeburg, Germany.
Bonnekoh
Bernd
B
Franke
Ingolf
I
Schön
Michael  P
M
Ulrich
Jens
J
Gollnick
Harald
H
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D000077271:Imiquimod; D015552:Injections, Intralesional; D007376:Interleukin-2 / Q000008:administration & dosage; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000556:secondary
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000970:Antineoplastic Agents; D007376:Interleukin-2; D000077271:Imiquimod