In a nutshell
The authors aimed to determine whether diphencyprone could be used as a topical treatment in cutaneously metastatic melanoma.
Some background
Metastatic (spread of the cancer) melanoma is typically treated with topical and intralesional immunotherapies (restore or enhance the immune systems ability to fight). Topical therapy is when the therapy is applied directly to the skin, while intralesional therapies are applied directly into the lesions.
In some cases spontaneous or immune-mediated (controlled by the immune system) recurrence can occur in cutaneously metastatic melanoma patients. Diphencyprone (DPCP, DPC) is a drug used to treat cutaneous metastatic melanoma and has previously been used as a treatment option for cutaneous warts. Treatment with diphencyprone can result in contact hypersensitivity (skin reaction to the drug).
Methods & findings
The aim of this study was to determine the effect of diphencyprone as a topical treatment for cutaneous metastatic melanoma.
50 patients were used in this study with an average age of 71 years. Each patient had recurrent disease: locally recurrent disease (return close to original cancer), in-transit melanoma (cancer deposits in lympn nodes more than 2 cm from the site of the original cancer) or metastatic cutaneous melanoma that could not be treated surgically or with further systemic therapy (treatments that travel through the bloodstream to affect cells all around the body).
23 patients (46%) experienced complete clearance of their melanoma when treated with diphencyprone. For these patients there was an average duration from treatment until clearance of lesions of 8 months and an average complete response time (disappearance of all signs of cancer as a result of treatment) of 17 months. 19 patients (38%) experienced a partial response (decrease in tumor size or symptoms in response to treatment) when treated with diphencyprone. 9 patients (18%) had no response to diphencyprone.
Two patients treated with both imiquimod (Aldera – topical treatment for skin disorders) and diphencyprone (aged 82 and 43 years) experienced accelerated clearance of metastatic melanoma.
In patients with thin disease (thinner lesions with less risk of spreading) the success rate of diphencyprone was 61% while the failure rate was 7%. In patients with bulky disease (thicker lesions with a greater risk of spreading) the success rate was 21% and the failure rate was 37%.
Factors such as the site of the disease (head and neck, arm, trunk, lower limb) or intensity of early response to diphencyprone had no impact on the success of the treatment.
The bottom line
The study concluded that diphencyprone is an effective treatment option for cutaneous metastatic melanoma.
The fine print
Patients kept their own diphencyprone diary so dosage and frequency of treatment may have been entered incorrectly.
What’s next?
If you are interested in further exploring diphencyprone as a treatment option please consult your doctor.
Published By :
Surgical oncology
Date :
Mar 01, 2014
