Imiquimod 5% cream for treatment of HIV-negative Kaposi's sarcoma skin lesions: A phase I to II, open-label trial in 17 patients.
BACKGROUND
Kaposi's sarcoma (KS), a virus-associated neoplasm, can be treated locally or systemically with interferon alfa. Therefore, imiquimod, an immune response modifier able to induce interferon-alpha secretion in situ, could prove a good local treatment for KS skin lesions.


OBJECTIVE
We sought to determine the efficacy and safety of imiquimod 5% cream for the topical treatment of classic or endemic KS skin lesions in patients who are HIV negative.


METHODS
We conducted a prospective, open-label, single center, phase II clinical trial. Imiquimod cream was applied under occlusion 3 times a week for 24 weeks. The main efficacy end points were the safety of topical imiquimod and the overall clinical response in patients evaluated on the basis of modified AIDS Clinical Trials Group criteria at 36 weeks. The statistical analysis was based on the intent-to-treat data set.


RESULTS
Seventeen patients were enrolled. Eight (47%) presented objective overall clinical response (2 complete and 6 partial responses). Tumor progression was noted in 6 patients. The most frequent side effects were local itching and erythema, seen in 9 patients (53%).


CONCLUSIONS
This was not a randomized placebo-controlled study and was restricted to a small number of patients.


CONCLUSIONS
Topical imiquimod 5% cream had antitumor activity in about half the patients with classic and endemic KS and was generally well tolerated.
Célestin Schartz
Noël Emile
NE
Department of Dermatology 2, Hôpital Saint Louis AP-HP, Paris, France. noel.schartz@noos.fr
Chevret
Sylvie
S
Paz
Carolina
C
Kerob
Delphine
D
Verola
Olivier
O
Morel
Patrice
P
Lebbé
Céleste
C
D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000627:therapeutic use*; D000287:Administration, Topical; D000368:Aged; D000634:Aminoquinolines / Q000009:adverse effects / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D000077271:Imiquimod; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D012514:Sarcoma, Kaposi / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000188:drug therapy*
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod