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Topical imiquimod may be effective alternative to surgery for melanoma in situ

Topical imiquimod cream may be an effective treatment for patients with melanoma in situ who are not candidates for surgery, according to long-term study outcomes published in Dermatologic Surgery.

Researchers conducted a retrospective chart review of 12 white patients with biopsy-proven melanoma in situ (seven men; average age, 79 years) who were treated with topical 5% imiquimod cream between 2004 and 2015 at the dermatology section of Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

Patients were instructed to apply the cream over the affected area for 6 to 12 weeks daily or on weekdays. Patients were excluded from analysis if they had undergone surgical treatment for melanoma in situ.

Median follow-up time was 5.5 years. Three patients applied topical 0.1% tazarotene cream daily for 2 weeks before initiating daily imiquimod therapy on weekdays for 12 weeks. The remaining patients applied 5% imiquimod cream daily for 6 to 8 weeks without pretreatment.

Two patients experienced local recurrence (17%), including one patient with a recurrence of melanoma in situ on the nasal dorsum 5.75 years after treatment completion and another patient who had three recurrences of melanoma, with the first occurring 10 months after the end of imiquimod treatment

“Findings support previously published studies that suggest that topical imiquimod has potential to be used successfully in the treatment of [melanoma in situ},” the researcher wrote. “However, this mode of therapy may have higher recurrence rates than the current standard of surgical excision; therefore, care should be taken in selecting the appropriate patient for this noninvasive therapeutic modality and long-term follow-up should be highly recommended.”

“Although surgery is still considered the gold standard for the treatment of [melanoma in situ], imiquimod may represent a potentially effective noninvasive treatment option for patients who are not surgical candidates,” the researchers concluded. – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.