The Effects of 5% Imiquimod Cream on High-Grade Vulval Intraepithelial Neoplasia

• Published in: Gynecologic oncology 2002-04, Vol.85 (1), p.67-70
• Main Authors: Todd, Richard W., Etherington, Ian J., Luesley, David M.
• Format: Article
• Language: English
• Subjects: Administration, Topical; Adult; Aminoquinolines - administration & dosage; Antineoplastic Agents - administration & dosage; Biological and medical sciences; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Human viral diseases; Humans; Infectious diseases; Medical sciences; Middle Aged; Ointments; Precancerous Conditions - drug therapy; Prospective Studies; Tumors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Vulvar Neoplasms - drug therapy
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.2001.6539

Objectives. The aim of this study was to investigate the effects of topical 5% Imiquimod (3M Pharmaceuticals, St. Paul, Minnessota) on high-grade vulval intraepithelial neoplasia (VIN). Methods. A prospective uncontrolled observational study was performed. Fifteen patients with histologically confirmed VIN 3 were asked to self-administer 5% Imiquimod cream to their vulval lesions up to three times weekly for 16 weeks. Review was conducted at 1, 2, 3, 4, 6, and 9 months postrecruitment. Lesions were photodocumented and at 4 months any areas demonstrating a clinical response were biopsied. Results. Of 15 patients recruited, 4 demonstrated a clinical improvement in their disease, 3 of whom had negative biopsies posttreatment. Local side effects limited the frequency of application such that 7 patients applied the cream once weekly, 6 twice weekly, and 2 three times weekly. Conclusions. 5% Imiquimod cream appears to have an effect when used on high-grade VIN. The frequency of application was limited by local side effects which may have reduced the clinical responses seen. Measures to alleviate local side effects may allow more aggressive use of Imiquimod and lead to improved responses.