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Ip MH, Tat L, Coroneo MT. The treatment of recurrent conjunctival and corneal intraepithelial neoplasia with interferon alfa-2b and retinoic acid: ~9 years' follow-up on tumor control. Ocul Surf 2020; 18:354-359. [PMID: 32311432 DOI: 10.1016/j.jtos.2020.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/13/2020] [Accepted: 04/12/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the long-term follow-up of recurrent conjunctival and corneal intraepithelial neoplasia (CCIN) treated with combination topical interferon alfa-2b and retinoic acid (I/RA). METHODS Our study represents a retrospective observational interventional series of 82 eyes from 82 patients from a single institution, reviewed for CCIN. All were administered topical interferon alfa-2b 1 million IU/mL QID and retinoic acid 0.01% every other day. Patients had been diagnosed by biopsy. A Kaplan-Meier survival analysis, Wilcoxon signed-rank test and a multivariate logistic regression were statistical tests used to correlate recurrence with patient and tumor variables. RESULTS 79 eyes assessed for CCIN diagnoses and treated with I/RA achieved tumor resolution. The median tumor-free follow-up was ~109.1 months with a median time to resolution being ~2.8 months. Our median treatment duration was ~11.3 months. The greatest difference in the mean total residual tumor size was identified between Months 0-1 [-7.63 mm2]. The difference in mean total residual tumor size remained significant till 36-months. A statistically significant correlation with recurrence was identified for biopsy type [OR 0.138]. 6 patients experienced papillary conjunctivitis which resolved with dosage reduction. CONCLUSIONS Combination I/RA was effective in treating CCIN lesions with few transient side effects. The combination of retinoids and interferons may represent a viable topical therapeutic agent with an extended tumor-free follow-up and a large proportion of our study's patients achieving >10 year's tumor-free follow-up. Our treatment duration is long, but by cost-comparing surgical against medical interventions, topical I/RA may serve as a safe and effective alternative.
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Affiliation(s)
- Matthew H Ip
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, NSW, Australia; The University of New South Wales at the Prince of Wales Hospital Clinical School, Randwick, NSW, Australia.
| | - Lien Tat
- Ophthalmic Surgeons, Randwick, NSW, Australia
| | - Minas T Coroneo
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, NSW, Australia; The University of New South Wales at the Prince of Wales Hospital Clinical School, Randwick, NSW, Australia; Ophthalmic Surgeons, Randwick, NSW, Australia
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da Cruz Silva LL, de Oliveira WRP, Sotto MN. Epidermodysplasia verruciformis: revision of a model of carcinogenic disease. SURGICAL AND EXPERIMENTAL PATHOLOGY 2019. [DOI: 10.1186/s42047-019-0046-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Treatment of conjunctival and corneal epithelial neoplasia with retinoic acid and topical interferon alfa-2b: long-term follow-up. Ophthalmology 2012; 119:1969-73. [PMID: 22704834 DOI: 10.1016/j.ophtha.2012.03.045] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 03/03/2012] [Accepted: 03/27/2012] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the long-term recurrence rate of conjunctival and corneal intraepithelial neoplasia (CIN) treated with retinoic acid and topical interferon alfa-2b. DESIGN Retrospective, noncomparative, interventional case series. PARTICIPANTS A total of 89 eyes of 89 patients from 1 institution who were treated between September 2003 and February 2010 for CIN lesions used topical interferon alfa 1 million IU/ml drops 4 times daily and retinoic acid 0.01% once every second day. METHODS Diagnosis was made by biopsy and impression cytology. Patients' notes and clinical photographs were reviewed, and data were analyzed. All eyes were monitored for the possibility of recurrence with a minimum of 1 year of follow-up from the time of documented clinical resolution. MAIN OUTCOME MEASURES All eyes were monitored for the possibility of recurrence with a minimum of 1 year of follow-up from the time of documented clinical resolution. RESULTS Complete clinical resolution of the CIN lesions was achieved in 87 of the 89 eyes treated (97.75%). Two of the 89 eyes treated (2.25%) had only a partial response to treatment; of these 2 patients, 1 was taking cyclosporine for keratitis sicca. For the 87 eyes with complete response, resolution occurred after a mean of 1.69 months (range, 19 days to 6.5 months). Mean follow-up after clinical resolution (tumor-free period) was 51.5 months (range, 11-84 months). Four of the 87 patients with complete response developed a mild allergic papillary conjunctivitis that settled on halving the interferon dose to 0.5 million IU drops and reducing the frequency to 3 times daily. Side effects were limited to 1 case of epithelial microcysts and 1 case of marginal keratitis. CONCLUSIONS In this group of patients observed with CIN lesions, combination treatment of topical retinoic acid and interferon alfa-2b was effective in treating lesions with minimal self-limited side effects with faster and greater resolution and a longer tumor-free period compared with studies using interferon alfa-2b alone. We hypothesize that topical all-trans retinoic acid and interferon alfa-2b may act synergistically. We believe that combination treatment of interferon alfa-2b and retinoic acid may offer a superior alternative to interferon alfa-2b alone in treating CIN.
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Abstract
A 70-year-old man presented complaining of lid and facial drooping and facial numbness, which progressed over several months. Magnetic resonance imaging of the head showed an enlarged right cavernous sinus. His past medical history was remarkable to squamous cell carcinoma of the face. The patient underwent a craniotomy with biopsy of the cavernous sinus that confirmed malignancy. High index of suspicion in a patient that presents facial drooping and/or numbness should alert ophthalmologists about the occurrence of perineural spread of a previous malignant lesion of the skin.
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Lee JJ, Kim NJ, Choung HK, Khwarg SI. Clinical Features and Management of Eyelid Sebaceous Gland Carcinoma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.2.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jong Joo Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Nam Ju Kim
- Department of Ophthalmology, Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Ho-Kyung Choung
- Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, Korea
| | - Sang In Khwarg
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
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Abstract
Squamous cell carcinoma (SCC) is the second most common eyelid malignancy and its incidence is increasing. Because of its variable clinical presentation, SCC may be difficult for even the experienced clinician to diagnose. Hence, all suspicious lesions warrant biopsy. As SCC behaviour may range widely in aggression, management should be individualized based on tumour (e.g. size, location, grade, histological subtype, previous recurrence, perineural invasion) and patient factors (e.g. age, health). Treatment of eyelid SCC should include margin control whenever possible for the highest cure rate in this high-risk area. Immediate histological monitoring of surgical margins with frozen sections or Mohs' micrographic surgery also allows for smaller margins of excision in an area where tissue conservation is important. Other special considerations in the periocular area include maintaining a high level of suspicion for perineural invasion as this may be associated with a poorer prognosis.
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Affiliation(s)
- Vanessa Limawararut
- Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
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7
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Garnier B, Simon E, Dumont T, Sellal S, Stricker M, Chassagne JF. [Goal cell carcinoma: really a low malignancy tumor?]. ACTA ACUST UNITED AC 2005; 106:16-21. [PMID: 15798647 DOI: 10.1016/s0035-1768(05)85795-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although basal cell carcinoma often presents as a fairly "benign" lesion early in its course, it remains the most frequent malignancy worldwide. Prevention, while possible, is not always optimal. We show that advanced basal cell carcinoma can be mutilating or even life threatening depending on location, type of lesion, or pre-existing co-morbidity. The consequences of this disease can be lessened if initial treatment does not underestimate its potential severity.
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Affiliation(s)
- B Garnier
- Service de Chirurgie Maxillo-Faciale et Plastique de la Face, C.H.U., Avenue du Maréchal de Lattre de Tassigny, Nancy, France
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8
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Affiliation(s)
- Edith Orion
- Dermatology Unit, Kaplan Medical Center, Rehovot, Israel
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Shin DM, Glisson BS, Khuri FR, Clifford JL, Clayman G, Benner SE, Forastiere AA, Ginsberg L, Liu D, Lee JJ, Myers J, Goepfert H, Lotan R, Hong WK, Lippman SM. Phase II and biologic study of interferon alfa, retinoic acid, and cisplatin in advanced squamous skin cancer. J Clin Oncol 2002; 20:364-70. [PMID: 11786562 DOI: 10.1200/jco.2002.20.2.364] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The purpose of this study was to test interferon alfa (IFNalpha), 13-cis-retinoic acid (13cRA), and cisplatin biochemotherapy in advanced squamous cell carcinoma (SCC) of the skin. PATIENTS AND METHODS Patients with advanced skin SCC received IFNalpha (5 x 10(6) IU/m(2), subcutaneous injection, three times a week), 13cRA (1 mg/kg, orally, daily), and cisplatin (20 mg/m(2), intravenous injection, weekly) in a phase II trial. The growth inhibition, cell-cycle, and apoptosis activity of these agents was evaluated in two skin SCC cell lines (SRB1-m7 and SRB12-p9). RESULTS Thirty-nine patients were enrolled. All were assessable for survival, 35 for response and toxicity (median follow-up was 38 months). The overall and complete response rates were 34% and 17%, respectively, with median durations of 9 and 35.4 months, respectively. The response rate was higher in locally advanced (67%) than metastatic (17%) disease (P =.007). Median survival was 14.6 months. One-, 2-, and 5-year survival rate estimates were 58%, 32%, and 21%, respectively. Toxicity included generally mild to moderate fatigue and mucocutaneous dryness, moderate to severe neutropenia (38%), and neutropenic fever (6%). There were no treatment-related deaths. In vitro growth inhibition and apoptosis effects of cisplatin were differential and inversely associated with those of retinoic acid and especially IFNalpha in two skin SCC lines. CONCLUSION The rising incidence, morbidity, and mortality of advanced skin SCC are a major challenge for clinical oncologists. Combined 13cRA, IFNalpha, and cisplatin was clinically active in extensive locally advanced disease. Each agent had independent, non-cross-resistant biologic effects in vitro, which may account for the combination's clinical activity.
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Affiliation(s)
- Dong M Shin
- Department of Thoracic/Head and Neck Medical Oncology, Diagnostic Imaging, Biostatistics, Head and Neck Surgery, and Clinical Cancer Prevention, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4095, USA
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10
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Anadolu R, Oskay T, Erdem C, Boyvat A, Terzi E, Gürgey E. Treatment of epidermodysplasia verruciformis with a combination of acitretin and interferon alfa-2a. J Am Acad Dermatol 2001; 45:296-9. [PMID: 11464195 DOI: 10.1067/mjd.2001.114575] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Epidermodysplasia verruciformis (EV) is an autosomal recessive disease characterized by the lifelong eruption of disseminated verrucae-like lesions. Numerous treatment modalities have been used to treat EV without benefit. Recently, retinoid and interferon therapies have been found to be of value in the treatment of EV. We present a case of EV that was treated with a combination of acitretin and interferon alfa-2a.
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Affiliation(s)
- R Anadolu
- Department of Dermatology, Faculty of Medicine, Ankara University, Turkey
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11
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Affiliation(s)
- P Gibbs
- Department of Dermatology, University of Colorado School of Medicine, Denver, Colorado 80262, USA
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12
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Look KY, Blessing JA, Nelson BE, Johnson GA, Fowler WC, Reid GC. A phase II trial of isotretinoin and alpha interferon in patients with recurrent squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Am J Clin Oncol 1998; 21:591-4. [PMID: 9856661 DOI: 10.1097/00000421-199812000-00012] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
From January 1993 through January 1996, 37 patients with unresectable squamous carcinoma of the cervix were entered on study and scheduled to receive oral isotretinoin 1 mg/kg per day with subcutaneous alpha interferon 6,000,000 units/day. A course was defined as 4 continuous weeks of therapy. The mean number of four-course cycles delivered was 1.8. One patient was ineligible because of wrong cell type and two were never treated. Thus, 34 patients were evaluable for toxicity. Eight patients were inevaluable for response. Five did not receive a complete 4-week course and three did not have additional tumor measurements; thus 26 were evaluable for response. Prior radiotherapy had been given to 25 patients and prior chemotherapy to 23 patients. There was no grade 4 neutropenia. The incidence of Gynecologic Oncology Group (GOG) grade 3 granulocytopenia and thrombocytopenia was 8.8% and 5.8%, respectively. Six patients (17.6%) developed grade 3 or worse nausea and vomiting. Four (11.7%) patients developed grade 3 neurologic symptoms. There were no complete responses and one partial response. The overall response rate was 3.8% (95% confidence interval, 0.1-19.6%). In this pretreated population, isotretinoin and alpha interferon in the dose and schedule employed exhibit minimal activity.
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Affiliation(s)
- K Y Look
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis 46202, USA
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13
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Keller KL, Fenske NA. Uses of vitamins A, C, and E and related compounds in dermatology: a review. J Am Acad Dermatol 1998; 39:611-25. [PMID: 9777769 DOI: 10.1016/s0190-9622(98)70011-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Vitamins have been increasingly used as prophylactic and therapeutic agents in the management of skin disorders. The current literature is replete with studies that promote the potential benefits of these compounds and attempt to elucidate their mechanisms of action. We review the literature and discuss the roles, safety, and efficacy of vitamins A, C, and E and related compounds in cutaneous health and disease.
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Affiliation(s)
- K L Keller
- Department of Dermatology, University of South Florida, College of Medicine, Tampa, USA
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15
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Abstract
Angiogenesis is the development of a blood supply to a given area of tissue. This area of tissue may be part of normal embryonic development, revascularization of a wound bed, or the stimulation of vessel growth by inflammatory or malignant cells. Angiogenesis is of crucial importance to the dermatologist, as it is of key importance in pathologic processes such as psoriasis, warts, and cutaneous malignancy, and it is required for optimal wound healing. Other dermatologic processes wherein angiogenesis is defective or uncontrolled are decubitus ulcers, stasis ulcers, pyogenic granulomas, hemangiomas, Kaposi's sarcoma, and possibly Spitz nevus, hypertrophic scars, and keloids. Recent advances in the understanding of growth factors will likely lead to advances in the treatment of skin cancer and psoriasis, and more rapid healing of wounds. In this review, I hope to summarize the most important growth factors, inhibitors of angiogenesis, and future directions in research and therapeutics involving angiogenesis.
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Affiliation(s)
- J L Arbiser
- Department of Dermatology, Massachusetts General Hospital, Boston, USA
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17
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Fierlbeck G, Schreiner T, Rassner G. Combination of highly purified human leukocyte interferon alpha and 13-cis-retinoic acid for the treatment of metastatic melanoma. Cancer Immunol Immunother 1995; 40:157-64. [PMID: 7728774 PMCID: PMC11037710 DOI: 10.1007/bf01517347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/1994] [Accepted: 01/10/1995] [Indexed: 01/26/2023]
Abstract
The effect of 13-cis-retinoic acid and highly purified human leukocyte interferon alpha (Alphaferon) therapy for metastatic melanoma was studied. A group of 17 patients with disseminated malignant melanoma were treated over a 6-month period. They received 60 mg 13-cis-retinoic acid/day continuously and ten cycles of interferon alpha (IFN alpha). IFN was administered by subcutaneous injection, at a daily dose of 6 x 10(6) IU Alphaferon. The 5-day treatment period was followed by an IFN-free interval of 2 weeks. We were able to observe an overall response rate of 30% with 12% complete responses (2 out of 17 patients). Sites of response included the skin, lung, liver and lymph nodes. All responses have now lasted over 6 months. Therapy was generally well tolerated and could be performed on an outpatient basis. Side-effects of this combination therapy did not exceed the established side-effects of the two substances. We also studied 2'-5'-oligoadenylate synthetase, beta 2-microglobulin and neopterin levels during the whole treatment course. All patients were within the normal range before treatment and a sharp rise occurred during each IFN cycle. The maximum being observed 24 h after the third injection. This indicates a high biological activity of IFN alpha administered cyclically during the whole treatment course. This finding also corresponds well with the absence of neutralizing antibodies before and after the whole treatment period.
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Affiliation(s)
- G Fierlbeck
- Department of Dermatology, University of Tübingen, Germany
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18
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Chimenti S, Cotellessa C, Peris K, Di Cristofaro S, Fargnoli M, Torlone G. Use of recombinant interferon alpha-2a in the treatment of squamous cell carcinoma. J DERMATOL TREAT 1995. [DOI: 10.3109/09546639509097175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- S Chimenti
- Department of Dermatology, University of L'Aquila, Italy
| | - C Cotellessa
- Department of Dermatology, University of L'Aquila, Italy
| | - K Peris
- Department of Dermatology, University of L'Aquila, Italy
| | | | - Mc Fargnoli
- Department of Dermatology, University of L'Aquila, Italy
| | - G Torlone
- Department of Dermatology, University of L'Aquila, Italy
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19
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Rackett SC, Rothe MJ, Grant-Kels JM. Diet and dermatology. The role of dietary manipulation in the prevention and treatment of cutaneous disorders. J Am Acad Dermatol 1993; 29:447-61. [PMID: 8349862 DOI: 10.1016/0190-9622(93)70210-k] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The role of dietary manipulation and vitamins in the prevention and treatment of certain skin diseases is reviewed. Manipulation of nutrition by either diet restriction or supplementation can effect cutaneous disorders such as skin cancer, wound healing, atopic dermatitis, psoriasis, and dermatitis herpetiformis.
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Affiliation(s)
- S C Rackett
- Department of Medicine, University of Connecticut Health Center, Farmington 06030
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20
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Dhingra K, Papadopoulos N, Lippman S, Lotan R, Legha SS. Phase II study of alpha-interferon and 13-cis-retinoic acid in metastatic melanoma. Invest New Drugs 1993; 11:39-43. [PMID: 8349434 DOI: 10.1007/bf00873908] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The combination of alpha-interferon and 13-cis-retinoic acid has shown significant activity against a number of human tumors. We conducted a phase II trial to test whether the combination would have a major response rate of 30% or more in patients with refractory, metastatic melanoma. Eleven patients were treated on the study. Alpha-interferon was administered subcutaneously three times a week at a dose of 10 million U/m2 and 13-cis-retinoic acid was administered orally at a dose of 1 mg/kg/day. No patient achieved a partial or complete remission. The combination of alpha-interferon and 13-cis-retinoic acid is unlikely to have significantly higher therapeutic activity than alpha-interferon alone.
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Affiliation(s)
- K Dhingra
- Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston
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21
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Affiliation(s)
- M W McBurney
- Department of Medicine, University of Ottawa, Ontario, Canada
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22
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Cohen PR. The use of gemfibrozil in a patient with chronic myelogenous leukemia to successfully manage retinoid-induced hypertriglyceridemia. THE CLINICAL INVESTIGATOR 1993; 71:74-7. [PMID: 8453265 DOI: 10.1007/bf00210973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Systemic retinoids are used in the management of chronic cutaneous conditions and life-threatening dermatoses. Unfortunately, drug-induced hypertriglyceridemia may necessitate either dose reduction or discontinuation of therapy. The purpose of this article is to describe the successful management of isotretinoin-induced hypertriglyceridemia with gemfibrozil in a leukemia patient. Sequential serum chemistries were performed prior to, during, and following treatment with a systemic retinoid and a lipid-regulating agent. A prompt and sustained normalization of fasting triglycerides occurred following the initiation of gemfibrozil in a patient with isotretinoin-induced hypertriglyceridemia. When retinoids are being used in the management of serious conditions, the initiation of therapy with gemfibrozil to reduce the elevated triglycerides may be appropriate in those patients with retinoid-induced hypertriglyceridemia.
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Affiliation(s)
- P R Cohen
- Department of Dermatology, University of Texas Medical School, Houston
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23
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Jones G, McLean J, Rosenthal D, Roberts J, Sauder DN. Combined treatment with oral etretinate and electron beam therapy in patients with cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome). J Am Acad Dermatol 1992; 26:960-7. [PMID: 1607416 DOI: 10.1016/0190-9622(92)70142-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Total skin irradiation for early-stage mycosis fungoides produces clinical remission in 90% of patients, but the median duration of remission is only 2 to 4 years. Etretinate has proven efficacy in advanced mycosis fungoides. Its potential as adjuvant therapy to radiation could be limited by toxicity from the combination. OBJECTIVE Our purpose was to determine whether oral etretinate at 1 mg/kg can be combined with 35 Gy of radiation without intensifying or prolonging the radiation reaction and to determine the relapse-free survival rate. METHODS Twenty-three patients began etretinate on day one of radiation and the dose was reduced for nose bleeds, dry skin, or hyperlipidemia. During the reaction skin toxicity questionnaires were completed weekly. Nine concurrent patients receiving only radiation completed identical forms. RESULTS Etretinate did not intensify the skin reaction but did prolong it by 2 weeks. At a median follow-up of 2 years the relapse-free survival rate in complete responders was similar to stage-matched concurrent and historic control subjects. CONCLUSIONS Both radiation and etretinate can be given together with acceptable toxicity and without compromising either therapy.
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Affiliation(s)
- G Jones
- Hamilton Regional Cancer Centre, Henderson Clinic, Ontario, Canada
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Abstract
Nonmelanoma skin cancer is the leading cause of cancer in the United States. Cutaneous squamous cell carcinoma is second only to basal cell carcinoma in prevalence and its incidence is increasing. The biology of squamous cell carcinoma is reviewed under the broad areas of etiology, immunobiology, biochemistry, metastatic potential, and therapy, with emphasis on prevention, diagnosis, and management.
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Affiliation(s)
- R E Kwa
- Division of Dermatology, University of California, Los Angeles 90024
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25
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Jones R, Wayte DM, Mitchell E, Beer WE. Basal-cell carcinoma of the breast--treatment with retinoids. Clin Exp Dermatol 1991; 16:448-50. [PMID: 1806321 DOI: 10.1111/j.1365-2230.1991.tb01233.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Retinoids have previously been described in the treatment of cutaneous malignancies and premalignancies. A case is reported of a patient with multifocal basal-cell carcinoma treated with a synthetic aromatic derivative of retinoic acid (etretinate) which resulted in complete resolution of the carcinoma confirmed by microscopy.
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Affiliation(s)
- R Jones
- Ysbyty Gwynedd General Hospital, Bangor, UK
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26
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Affiliation(s)
- N L Vargo
- Department of Dermatology, Oregon Health Sciences University, Portland
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27
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Nagatani T, Matsuzaki T, Kim S, Baba N, Osawa J, Sugiyama A, Komatsu H, Ichiyama S, Takahashi Y, Miyamoto H. Treatment of cutaneous T-cell lymphomas (CTCL) with extracorporeal photochemotherapy--preliminary report. J Dermatol 1990; 17:737-45. [PMID: 2086618 DOI: 10.1111/j.1346-8138.1990.tb03022.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Since August of 1988, we have treated seven CTCL patients with extracorporeal photochemotherapy, including two with tumor-stage mycosis fungoides (MF) showing mucinous degeneration, two with plaque-stage MF, and two with erythrodermatous MF. One was withdrawn just after the first trial. For each patient, the phenotypes of peripheral blood lymphocytes were analyzed by flow cytometry in terms of the percentages of OKT11, OKT3, OKT4, Leu9, OKT8, B1, Tac, OKT9, OKIa1, Leu7, Leu3a/4B4, and Leu3a/2H4 cells. These parameters were compared with the clinical responses according to skin score. The two patients with tumors died, but the five patients without tumors did not. Three of the 6 patients responded to the treatment. Side effects that are often associated with standard chemotherapy, such as bone marrow suppression, gastrointestinal symptoms and hair loss, were not observed. One cardiovascular event (1 patient) occurred. No significant changes in T-cell subsets were seen during the course of therapy. These preliminary data suggest that extracorporeal photochemotherapy may be effective for CTCL other than tumor-stage MF.
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Affiliation(s)
- T Nagatani
- Department of Dermatology, Yokohama City University School of Medicine, Japan
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28
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Abstract
The synthetic retinoids, isotretinoin (Accutane) and etretinate (Tegison) are vitamin A analogs. They affect epithelial differentiation and thus have potential for therapy for disorders of epithelial maturation such as keratinization defects of cutaneous neoplasia. The pharmacology, indications for use, clinical experience, potential toxicities, and recommended monitoring of these drugs are discussed.
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Affiliation(s)
- H T Power
- Department of Medicine, University of California School of Veterinary Medicine, Davis
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Neades GT, Hughes LE. The management of metastatic melanoma. J DERMATOL TREAT 1990. [DOI: 10.3109/09546639009086752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- G. T. Neades
- Department of Surgery, University of Wales College of Medicine, Cardiff, UK
| | - L. E. Hughes
- Department of Surgery, University of Wales College of Medicine, Cardiff, UK
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