Responses to Topical Diphenylcyclopropenone as an Adjunct Treatment for In-Transit Melanoma: A Tertiary Referral Center Experience

Dermatol Surg. 2018 Dec;44(12):1501-1508. doi: 10.1097/DSS.0000000000001603.

Abstract

Background: In-transit cutaneous metastases occur in 5% to 10% of patients with melanoma. Recently, topical diphenylcyclopropenone (DPCP) has been described as a treatment option.

Objective: To evaluate efficacy of DPCP in treatment of in-transit cutaneous melanoma.

Methods: The authors retrospectively reviewed the records of 13 consecutive patients with in-transit metastases treated with topical DPCP between March 1, 2013, and January 31, 2017. The authors recorded the response of in-transit cutaneous melanoma lesions treated with DPCP measured by clinical examination.

Results: Among the 13 patients, 9 patients completed at least a 1-month course of DPCP treatment. Of these 9 patients, 6 (66.7%) maintained either stable disease or had a partial or complete regression, and 3 (33.3%) had progressive disease. Patients with less burden of disease (e.g., <15 lesions) responded more favorably than those with a greater burden of disease (e.g., >25 lesions or plaques). Both patients who received DPCP alone had progression of their cutaneous lesions. One patient who did not become sensitized to DPCP died within 2 months, and his anergy likely reflecting immense burden of disease.

Conclusion: Topical DPCP is a low-cost, patient-applied treatment option for in-transit melanoma, most effective for patients with relatively low tumor burden and localized disease.

MeSH terms

  • Adjuvants, Immunologic / administration & dosage*
  • Administration, Cutaneous
  • Aged
  • Cyclopropanes / administration & dosage*
  • Disease Progression
  • Female
  • Haptens / administration & dosage
  • Humans
  • Immunotherapy
  • Male
  • Melanoma / immunology
  • Melanoma / secondary
  • Melanoma / therapy*
  • Middle Aged
  • Neoplastic Cells, Circulating / immunology
  • Retrospective Studies
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Tertiary Care Centers
  • Treatment Outcome
  • Tumor Burden

Substances

  • Adjuvants, Immunologic
  • Cyclopropanes
  • Haptens
  • diphenylcyclopropenone