Bowen's Disease (Squamous Cell Carcinoma In Situ) in Immunosuppressed Patients Treated with Imiquimod 5% Cream and a COX Inhibitor, Sulindac: Potential Applications for This Combination of Immunotherapy

Authors: Smith, Kathleen J.1; Germain, Margeruite1; Skelton, Henry2

Source: Dermatologic Surgery, Volume 27, Number 2, February 2001 , pp. 143-146(4)

Publisher: Blackwell Publishing

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Abstract:

Background.

Patients with chronic lymphocytic leukemia (CLL) often have a protracted course. However, all these patients are immunosuppressed and may have a high incidence of cutaneous malignancies. Objective.

To determine if combination therapy using topical imiquimod cream 5% and the oral cyclooxygenase (COX) inhibitor are useful in the therapy of squamous cell carcinoma in situ (SCC in situ)/Bowen's disease in patients with long-standing CLL. Methods.

Five CLL patients with head and neck cutaneous SCC in situ, which met criteria for Bowen's disease, were treated with topical 5% topical imiquimod cream and an oral COX inhibitor, sulindac 200 mg twice a day. Results.

All patients showed clinical resolution and histologic clearing of the tumors after 16 weeks of therapy. Conclusion.

The local immune modulator, 5% imiquimod, in combination with a COX inhibitor, with its many potential antitumor effects may stimulate the innate and possibly the adaptive immune responses to clear these malignancies.

Document Type: Research article

Affiliations: 1: National Naval Medical Center, Bethesda, Maryland, and 2: Laboratory Corporation of America, Herndon, Virginia

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