Imiquimod Cream Effective for Bowen"s Disease

NEW YORK JUL 03, 2006 (Reuters Health) - Imiquimod cream effectively treats cutaneous squamous cell carcinoma (SCC) -- aka, Bowen"s disease -- according to a report in the June issue of the Journal of the American Academy of Dermatology.
 
Surgical excision is the most effective treatment for cutaneous SCC, the authors explain, but no treatment appears to be ideal.
 
Dr. Girish K. Patel from University Hospital of Wales, Cardiff, UK and colleagues investigated the effectiveness of topical imiquimod 5% cream as monotherapy versus placebo in 31 patients with histologically proven cutaneous SCC in situ.
 
Nine of the 12 imiquimod-treated patients completing the study had complete resolution of the treated lesion, the authors report, compared with none of the 16 patients in the placebo group.

Four of six patients who had failed to respond to conventional treatment achieved clinical resolution with imiquimod, the results indicate.
 
The mean change in lesion area was significantly greater in the imiquimod treatment group than in the placebo group, the researchers note, and there were no recurrences at week 52 in the imiquimod group.
 
The three imiquimod-treated patients who failed to respond to treatment had hyperkeratosis on their initial diagnostic biopsy specimen, the report indicates.
 
Nineteen patients experienced adverse events, all of which resolved spontaneously or with stopping the study medication for up to 5 days, the investigators say. Only five adverse events in five patients were assessed as possibly related to the study treatment.
 
"Further studies are required to firmly establish the safety and efficacy of imiquimod 5% cream in the treatment of cutaneous SCC in situ," the authors conclude. They cite the need for studies to establish an ideal treatment regimen and to determine whether the treatment is cost-effective.

"It also remains to be determined if repeated treatment or alternative treatment alone or in combination (with) imiquimod should be used for initial nonresponders," the researchers add.
 
SOURCE:

• J Am Acad Dermatol 2006;54:1025-1032.