title: Immunosuppression as a Possible Risk Factor for Interferon Nonresponse in Ocular Surface Squamous Neoplasia.
abstract: OBJECTIVE
  The mechanism by which ocular surface squamous neoplasia (OSSN) responds to topical interferon-alpha-2b (IFNα2b) is not known. We report the cases of 3 immunosuppressed patients whose tumors did not respond to topical IFNα2b therapy. The purpose of this series is to shed light on potential mechanisms of IFNα2b in OSSN.
  
  
  METHODS
  Retrospective case series of 3 immunosuppressed patients whose biopsy-proven OSSN did not respond to topical IFNα2b treatment.
  
  
  RESULTS
  Three white, immunosuppressed males (mean age 70 years, range 66-76) were diagnosed with OSSN. Topical IFNα2b 1 million units/mL was administered 4 times a day and used for a mean of 5 months (range 2-7 mo) without an adequate response. All patients were then switched to 5-fluorouracil. Successful eradication of OSSN was achieved in 2 cases, and improvement of OSSN in another. The latter patient was switched to mitomycin-C with subsequent resolution of OSSN.
  
  
  CONCLUSIONS
  These cases suggest that an intact immune system may be an important link between IFNα2b therapy and tumor resolution. As such, topical IFNα2b may not be an optimal choice for patients with underlying immunosuppression. It may be more effective in this patient population to switch to a non-immune-modulating therapy such as 5-fluorouracil or mitomycin-C.
authors.affiliation: *Department of Ophthalmology, Miami Veterans Affairs Medical Center; †Bascom Palmer Eye Institute, University of Miami, Miami, FL; and ‡Jackson Memorial Hospital, Miami, FL.
authors.forename: Noy
authors.initials: N
authors.lastname: Ashkenazy
authors.forename: Carol L
authors.initials: CL
authors.lastname: Karp
authors.forename: Gaofeng
authors.initials: G
authors.lastname: Wang
authors.forename: Carolina Mercado
authors.initials: CM
authors.lastname: Acosta
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D003230:Conjunctival Neoplasms / Q000188:drug therapy*; D003316:Corneal Diseases / Q000188:drug therapy*; D005134:Eye Neoplasms / Q000188:drug therapy*; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007155:Immunologic Factors / Q000627:therapeutic use*; D007165:Immunosuppression Therapy; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D009883:Ophthalmic Solutions; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure
chemical_list: D000964:Antimetabolites, Antineoplastic; D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009883:Ophthalmic Solutions; D011994:Recombinant Proteins; D005472:Fluorouracil