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.
  
  
  CONCLUSIONS
  Small number of patients, retrospective review of charts, and lack of a comparison group were limitations.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Vivian Y
authors.initials: VY
authors.lastname: Shi
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Khiem
authors.initials: K
authors.lastname: Tran
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Forum
authors.initials: F
authors.lastname: Patel
authors.affiliation: Department of Dermatology, Yale-New Haven Medical Center, New Haven, Connecticut.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Leventhal
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Thomas
authors.initials: T
authors.lastname: Konia
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Maxwell A
authors.initials: MA
authors.lastname: Fung
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Reason
authors.initials: R
authors.lastname: Wilken
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Miki Shirakawa
authors.initials: MS
authors.lastname: Garcia
authors.affiliation: Department of Dermatology, Veterans Affairs Hospital, Mather, California.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Fitzmaurice
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Jayne
authors.initials: J
authors.lastname: Joo
authors.affiliation: Department of Radiation Oncology, University of California, Davis, California.
authors.forename: Arta M
authors.initials: AM
authors.lastname: Monjazeb
authors.affiliation: Department of Dermatology, University of California, Davis, California.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Burrall
authors.affiliation: Department of Dermatology, Yale-New Haven Medical Center, New Haven, Connecticut.
authors.forename: Brett
authors.initials: B
authors.lastname: King
authors.affiliation: Department of Surgical Oncology, University of California, Davis, California.
authors.forename: Steve
authors.initials: S
authors.lastname: Martinez
authors.affiliation: Department of Internal Medicine, Division of Hematology/Oncology, University of California Davis Medical Center, Davis, California.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Christensen
authors.affiliation: Department of Dermatology, University of California, Davis, California. Electronic address: emaverakis@ucdavis.edu.
authors.forename: Emanual
authors.initials: E
authors.lastname: Maverakis
mesh_terms: D000287:Administration, Topical; D000634:Aminoquinolines / Q000008:administration & dosage*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D015552:Injections, Intralesional; D007376:Interleukin-2 / Q000008:administration & dosage*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary; D009361:Neoplasm Invasiveness / Q000473:pathology; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012176:Retinoids / Q000008:administration & dosage*; D012189:Retrospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D000096142:Cutaneous Malignant Melanoma
chemical_list: D000634:Aminoquinolines; D007376:Interleukin-2; D012176:Retinoids; D000077271:Imiquimod
keywords: imiquimod; interleukin; intralesional; metastatic melanoma; pemphigus vulgaris; retinoid