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

J Am Acad Dermatol. 2015 Oct;73(4):645-54. doi: 10.1016/j.jaad.2015.06.060. Epub 2015 Aug 7.

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.

Keywords: imiquimod; interleukin; intralesional; metastatic melanoma; pemphigus vulgaris; retinoid.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Topical
  • Aminoquinolines / administration & dosage*
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Imiquimod
  • Injections, Intralesional
  • Interleukin-2 / administration & dosage*
  • Male
  • Melanoma / drug therapy*
  • Melanoma / secondary
  • Melanoma, Cutaneous Malignant
  • Neoplasm Invasiveness / pathology
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Retinoids / administration & dosage*
  • Retrospective Studies
  • Risk Assessment
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Treatment Outcome

Substances

  • Aminoquinolines
  • Interleukin-2
  • Retinoids
  • Imiquimod