Effect of skin injection of interleukin-2 in advanced skin melanoma

The authors analyzed the effect of combination treatment with inerleukin-2 (Proleukin) injected in skin, with imiquimod (Zyclara) ointment in advanced skin cancer.

In advanced skin melanoma (stage III/IV), cancer spreads rapidly from the skin to the surrounding lymph nodes and the lymphatic channels (important part of blood circulation). This is called in-transit metastasis. The standard treatment for this condition has been surgery with or without radiotherapy. Radiotherapy is directing a beam of radiation to the tumor site to kill cancer cells. However relapse of disease is common with these treatments.

Immunotherapy is an alternate treatment option. It uses the body’s own immune system to fight cancer. Inerleukin-2 is an example of such treatment. Injection of inerleukin-2 directly onto the lesion/tumor (intralesional injection) has shown promising results.

A combination treatment of interleukin-2 with effective skin ointments such as imiquimod and retinoid (vitamin cream) could benefit patients in advanced skin melanoma.

The authors aimed to evaluate the effectiveness of interleukin-2 injected into the skin combined with imiquimod and retinoid ointments in advanced skin melanoma.

11 patients were included in this study. All were first treated with interleukin-2 for 4 to 6 weeks. Then the skin ointments imiquimod and retinoid were applied for 7 days every month for 1 year. The average follow-up time was 24 months.

All patients had a complete response (100% disappearance of detectable tumors). The 2-year survival rate following treatment was 82%. The treatment-related side effects were mild to moderate. These were nausea, low blood pressure and loss of appetite. 6 patients experienced rigors (the "chills" that go along with a fever) in the 3-6 hours following interleukin-2 treatment.

The authors concluded that skin injection of interleukin-2 in combination with imiquimod and retinoid was well tolerated and was a promising treatment option in advanced skin melanoma.

This study included a small number of patients. A larger patient population and a control group of patients (patients witout the treatment) are needed for the results to be widely applied.