A pilot study of topical imiquimod therapy for the treatment of recurrent extramammary Paget's disease Journal Article


Authors: Cowan, R. A.; Black, D. R.; Hoang, L. N.; Park, K. J.; Soslow, R. A.; Backes, F. J.; Gardner, G. J.; Abu-Rustum, N. R.; Leitao, M. M. Jr; Eisenhauer, E. L.; Chi, D. S.
Article Title: A pilot study of topical imiquimod therapy for the treatment of recurrent extramammary Paget's disease
Abstract: Objective. The objective of this prospective pilot study was to assess the clinical and histologic effects of topical imiquimod therapy on recurrent extramammary Paget's disease of the vulva. Methods. Patients with biopsy-proven recurrent extramammary Paget's disease presenting to the gynecology outpatient services at two participating institutions were recruited for conservative treatment with 5% imiquimod cream from 2007 to 2011. The topical cream was to be applied 3 times per week for 12 weeks. Punch biopsy and photography were performed at baseline and at the 12-week time point. Results. Eight patients from two institutions were enrolled. Complete clinical and histologic response was achieved in 6 (75%) patients by the 12-week follow-up appointment Of the two remaining patients, one had a complete clinical response but no significant histologic response; the other patient was removed from the study protocol secondary to intolerable local irritation. Two patients continue to have no evidence of disease after a median follow-up of 35 months. Five are alive with disease. No patients progressed to invasive cancer while receiving therapy. Conclusion. Topical 5% imiquimod cream is a safe and feasible option for women suffering from recurrent extramammary Paget's disease of the vulva, and should be considered as a viable alternative to surgical management. Given the rare nature of this disease, additional multi-institutional prospective studies should be conducted to explore the efficacy of this treatment regime. (C) 2016 Elsevier Inc. All rights reserved.
Keywords: excision; imiquimod; vulvar cancer; quality-of-life; 5-percent cream; vulva; extramammary paget's disease
Journal Title: Gynecologic Oncology
Volume: 142
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2016-07-01
Start Page: 139
End Page: 143
Language: English
ACCESSION: WOS:000379100100025
DOI: 10.1016/j.ygyno.2016.04.028
PROVIDER: wos
PMCID: PMC4917425
PUBMED: 27112632
Notes: Article -- Source: Wos
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  1. Ginger J Gardner
    272 Gardner
  2. Destin Rene Black
    20 Black
  3. Dennis S Chi
    711 Chi
  4. Mario Leitao
    577 Leitao
  5. Kay Jung Park
    308 Park
  6. Robert Soslow
    797 Soslow
  7. Renee Antonette Woodburn Cowan
    32 Cowan
  8. Lien N Hoang
    25 Hoang