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Treatment of Cutaneous Squamous Cell Carcinomas by Intralesional Interferon Alfa-2b Therapy
Libby Edwards, MD;
Brian Berman, MD, PhD;
Ronald P. Rapini, MD;
David A. Whiting, MD;
Stephen Tyring, MD, PhD;
Hubert T. Greenway, Jr, MD;
Steven P. Eyre, MD;
Daniel J. Tanner, MD;
Eugene L. Taylor, MS;
Edwin Peets, PhD;
Kenneth A. Smiles, PhD
Arch Dermatol. 1992;128(11):1486-1489.
Abstract
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• Background and Design.—
Intralesional recombinant interferon alfa-2b has been shown to be effective in the treatment of actinic keratoses and basal cell carcinomas. This open-label study was designed to evaluate the effectiveness and cosmetic result of this therapy on actinically induced, primary cutaneous squamous cell carcinomas. Thirty-six squamous cell carcinomas (28 invasive lesions and 8 in situ lesions) ranging in size from 0.5 to 2.0 cm in the longest dimension were treated with interferon alfa-2b 1.5 million units injected intralesionally three times per week for 3 weeks. Eighteen weeks following therapy, the treatment sites were excised and examined for histologic evidence of remaining tumor.
Results.—
Thirty-three (97.1%) of 34 evaluable lesions revealed an absence of squamous cell carcinoma histologically after therapy, although three biopsy specimens (8.8%) obtained after treatment showed actinic keratoses, for an overall complete response rate of 88.2%. The lesion not eliminated after treatment was an invasive squamous cell carcinoma. The investigators and patients independently judged 93.9% of cases to have a very good or excellent cosmetic result. Adverse reactions were limited to those influenzalike symptoms well recognized to occur with interferon therapy and these were well tolerated. Only one patient discontinued therapy due to side effects.
Conclusions.—
This trial demonstrates that intralesional interferon is effective in the treatment of small sun-induced squamous cell carcinomas with well-tolerated side effects and a highly acceptable cosmetic result.
(Arch Dermatol. 1992;128:1486-1489)
Author Affiliations
From the University of Arizona College of Medicine (Dr Edwards), the Martinez (Calif) Veterans Administration Medical Center (Dr Berman), the University of Texas Health Science Center, Houston (Drs Rapini and Eyre), the University of Texas Medical Branch, Galveston (Dr Tyring), the Scripps Clinic and Research Foundation, La Jolla, Calif (Dr Greenway), and the Schering-Plough Research Corp, Kenilworth, NJ (Drs Tanner, Peets, and Smiles and Mr Taylor). Dr Edwards is now with the Carolinas Medical Center, Charlotte, NC. Dr Berman is now at Mt Sinai Medical Center, Miami Beach, Fla. Drs Whiting and Eyre are in private practice in Dallas, Tex, and Provo, Utah, respectively. Dr Smiles is with Oclassen Pharmaceuticals Inc, San Rafael, Calif.
Footnotes
Accepted for publication July 15, 1992.
Presented, in part, at the International Society for Interferon Research, Nice, France, November 7, 1991; the Annual Meeting of the American Academy of Dermatology, Dallas, Tex, December 11, 1991; and the Southern Region for Investigative Dermatology, New Orleans, La, January 31, 1992.
Reprint requests to Department of Internal Medicine, Carolinas Medical Center, PO Box 32861, Charlotte, NC 28232-2861 (Dr Edwards).
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