Topical Imiquimod in Primary Cutaneous Extramammary Paget's Disease: A Systematic Review

Extramammary Paget's disease (EMPD) is subclinical in extent and multifocal in nature. There is no global consensus for treatment, so its management represents a challenge in clinical practice. Therefore, we conducted a systematic review through the main electronic databases to assess the effec...

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Bibliographic Details
Published in:Cancers 2023-11, Vol.15 (23), p.5665
Main Authors: Mayo-Martínez, Fátima, Moro, Ruggero, Millán-Esteban, David, Ríos-Viñuela, Elisa, Bautista, Iker Javier, Nagore, Eduardo, Sanmartín, Onofre, Llombart, Beatriz
Format: Article
Language:English
Subjects:
Cancer
Case reports
Conflicts of interest
Content analysis
Evidence-based medicine
Imiquimod
Immunotherapy
Medical prognosis
Medical research
Medicine, Experimental
Meta-analysis
Metastasis
Morbidity
Patients
Performance evaluation
Photodynamic therapy
Quasi-experimental methods
Radiation therapy
Surgery
Systematic review
Tumors
Citations: Items that this one cites
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Summary:Extramammary Paget's disease (EMPD) is subclinical in extent and multifocal in nature. There is no global consensus for treatment, so its management represents a challenge in clinical practice. Therefore, we conducted a systematic review through the main electronic databases to assess the effectiveness of topical imiquimod in cutaneous EMPD and to discuss its management. Finally, 24 studies involving a total of 233 EMPD patients treated with topical imiquimod were selected. The topical imiquimod response rate was 67%, and the complete response (CR) rate was 48%. Patients were treated with a three-four times a week regimen in most cases, ranging between 2 to 52 weeks. In addition, imiquimod was applied as an adjunctive treatment in 21 patients, achieving a CR rate of 71%. Consequently, imiquimod therapy could achieve a good response ratio as a first-line treatment, as adjuvant and neo-adjuvant therapy, and as a treatment for recurrent disease. The heterogeneity between studies and the lack of a control arm made it impossible to conduct a meta-analysis. To improve the quality of evidence on EMPD, multicenter studies are essential to collect a larger number of patients and, consequently, obtain high-quality evidence to standardize treatment. The Prospero registration number is CRD42023447443.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15235665