Clinical and Molecular Responses in High-Grade Intraepithelial Neoplasia Treated with Topical Imiquimod 5
Objective: To assess the clinical and molecular response of patients with recurrent high-grade vulvar, vaginal, or cervical intraepithelial neoplasia treated with topical 1–2(2-methylpropyl)-1 H -imidazo [4,5- c ] quinolin-4-amine (imiquimod) cream 5%, an immune response modifier with known efficacy...
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Published in | Clinical cancer research Vol. 7; no. 10; pp. 3031 - 3033 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Philadelphia, PA
American Association for Cancer Research
01.10.2001
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Subjects | |
Online Access | Get full text |
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Summary: | Objective: To assess the clinical and molecular response of patients with recurrent high-grade vulvar, vaginal, or cervical intraepithelial
neoplasia treated with topical 1–2(2-methylpropyl)-1 H -imidazo [4,5- c ] quinolin-4-amine (imiquimod) cream 5%, an immune response modifier with known efficacy in the treatment of external genital
warts.
Methods: This is the first case series in the peer-reviewed literature reporting the use of imiquimod in high-grade intraepithelial
neoplasia of the lower genital tract. Eight patients with high-grade intraepithelial neoplasia were treated with imiquimod
in the gynecological oncology clinic and the HIV gynecology clinic at The University of Texas Medical Branch at Galveston.
Frozen biopsies were available for RNA extraction on four patients before and after therapy. Using semiquantitative reverse
transcription-PCR, we measured RNA levels of IFNs α and γ, 2′,5′-oligoadenylate synthetase, as well as CD4 and CD8 lymphocyte
markers.
Results: Of the patients treated, four had complete responses, two had partial responses, one progressed, and one did not tolerate
the therapy. Of the four complete responders, two remained disease-free (mean follow-up, 33 months). 2′,5′-Oligoadenylate
synthetase RNA expression showed an increased trend after therapy.
Conclusions: These results obtained in this small and heterogeneous group merit further study in the use of topical 5% imiquimod use in
the treatment of intraepithelial neoplasia. An important mechanism of action of imiquimod may involve 2′,5′-oligoadenylate
synthetase antiviral activity. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1078-0432 1557-3265 |