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Items 1 to 27 of about 27
1. van Poelgeest MI, van Seters M, van Beurden M, Kwappenberg KM, Heijmans-Antonissen C, Drijfhout JW, Melief CJ, Kenter GG, Helmerhorst TJ, Offringa R, van der Burg SH: Detection of human papillomavirus (HPV) 16-specific CD4+ T-cell immunity in patients with persistent HPV16-induced vulvar intraepithelial neoplasia in relation to clinical impact of imiquimod treatment. Clin Cancer Res; 2005 Jul 15;11(14):5273-80
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  • [Title] Detection of human papillomavirus (HPV) 16-specific CD4+ T-cell immunity in patients with persistent HPV16-induced vulvar intraepithelial neoplasia in relation to clinical impact of imiquimod treatment.
  • PURPOSE: Topical application of the immune response modifier imiquimod is an alternative approach for the treatment of human papillomavirus (HPV)-positive vulvar intraepithelial neoplasia (VIN) and aims at the immunologic eradication of HPV-infected cells.
  • We have charted HPV16-specific immunity in 29 patients with high-grade VIN and examined its role in the clinical effect of imiquimod treatment.
  • EXPERIMENTAL DESIGN: The magnitude and cytokine polarization of the HPV16 E2-, E6-, and E7-specific CD4+ T-cell response was charted in 20 of 29 patients by proliferation and cytokine bead array.
  • The relation between HPV16-specific type 1 T-cell immunity and imiquimod treatment was examined in a group of 17 of 29 patients.
  • In eight of these patients, T-cell reactivity was associated with IFNgamma production.
  • Fifteen of the women treated with imiquimod were HPV16+, of whom eight displayed HPV16 E2- and E6-specific T-cell immunity before treatment.
  • Of these 11 responders, eight patients displayed HPV16-specific type 1 CD4+ T-cell immunity, whereas three lacked reactivity.
  • Notably, the four patients without an objective clinical response also lacked HPV16-specific type 1 T-cell immunity.
  • CONCLUSIONS: HPV16-specific IFNgamma-associated CD4+ T-cell immunity, although not essential for imiquimod-induced regression of VIN lesions, may increase the likelihood of a strong clinical response (P = 0.03).
  • [MeSH-major] Carcinoma in Situ / drug therapy. Carcinoma in Situ / virology. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / virology
  • [MeSH-minor] Adjuvants, Immunologic. Adult. Aged. Aminoquinolines. CD4-Positive T-Lymphocytes. Female. Humans. Immunity, Cellular. Interferon-gamma / immunology. Middle Aged. Papillomaviridae. Treatment Outcome

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  • (PMID = 16033846.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 82115-62-6 / Interferon-gamma; 99011-02-6 / imiquimod
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2. Winters U, Daayana S, Lear JT, Tomlinson AE, Elkord E, Stern PL, Kitchener HC: Clinical and immunologic results of a phase II trial of sequential imiquimod and photodynamic therapy for vulval intraepithelial neoplasia. Clin Cancer Res; 2008 Aug 15;14(16):5292-9
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  • [Title] Clinical and immunologic results of a phase II trial of sequential imiquimod and photodynamic therapy for vulval intraepithelial neoplasia.
  • PURPOSE: High-risk human papillomavirus (HPV)-associated vulval intraepithelial neoplasia (VIN) is difficult to treat by excision or ablation because of high recurrence rates.
  • Small studies of photodynamic therapy (PDT) and imiquimod treatments have shown some success and function at least in part through stimulation of local immune responses.
  • Indeed, there is evidence that immunosuppressed individuals have higher rates of VIN, suggesting immune control is relevant.
  • EXPERIMENTAL DESIGN: In the study, 20 women with high-grade VIN were treated with topical imiquimod and the PDT sequentially.
  • Vulval biopsy and blood were taken pretreatment and, after imiquimod and PDT, with follow up for 1 year.
  • RESULTS: The treatment was well-tolerated.
  • The nonresponders showed a significantly higher level of T regulatory cells in the lesions after imiquimod treatment.
  • CONCLUSIONS: The response rates are clinically relevant, and the treatment regimen was feasible for the majority.
  • Initial nonresponders to imiquimod seem to be relatively refractory, and this may derive from their unfavorable local immune environment, in particular, the increased proportions of T regulatory cells, possibly the limiting action and/or development of any HPV T-cell immunity.
  • The potential benefit of this treatment is its ability to treat multifocal disease.
  • [MeSH-major] Aminoquinolines / administration & dosage. Antineoplastic Agents / administration & dosage. Carcinoma in Situ / drug therapy. Photochemotherapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Antigens, CD / metabolism. Combined Modality Therapy. Female. Fluorescent Antibody Technique. Humans. Immunohistochemistry. Lymphocytes, Tumor-Infiltrating / drug effects. Lymphocytes, Tumor-Infiltrating / immunology. Middle Aged. T-Lymphocytes, Regulatory

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  • (PMID = 18698049.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Grant] United Kingdom / Cancer Research UK / /
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antigens, CD; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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3. Bifulco G, Mandato VD, Piccoli R, Giampaolino P, Mignogna C, Mignogna MD, Costagliola L, Nappi C: Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus. BMC Cancer; 2010;10:324
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  • [Title] Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus.
  • Here, we report the first case of a woman affected with SLE presenting with early invasive squamous cell carcinoma (SCC) arising from Pemphigus Vulgaris of the vulva.
  • CASE PRESENTATION: A 27-year-old Caucasian woman was admitted to our Gynaecology Unit for bleeding vegetant lesions of the vulva.
  • Biopsy showed concomitant PV and vulvar intraepithelial neoplasia (VIN) grade 3.
  • One month later a new biopsy revealed progression from VIN 3 to early SCC.
  • Despite chemotherapy, no remission of disease was observed.
  • She died six months after diagnosis CONCLUSION: Our case underlines PV as another chronic inflammatory disease of the lower genital tract predisposing to VIN-SCC.
  • [MeSH-major] Carcinoma in Situ / etiology. Carcinoma, Squamous Cell / etiology. Lupus Erythematosus, Systemic / complications. Pemphigus / complications. Vulvar Diseases / complications. Vulvar Neoplasms / etiology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Disease Progression. Fatal Outcome. Female. Humans. Neoplasm Invasiveness. Neoplasm Staging. Time Factors


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4. Hillemanns P, Untch M, Dannecker C, Baumgartner R, Stepp H, Diebold J, Weingandt H, Pröve F, Korell M: Photodynamic therapy of vulvar intraepithelial neoplasia using 5-aminolevulinic acid. Int J Cancer; 2000 Mar 1;85(5):649-53
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  • [Title] Photodynamic therapy of vulvar intraepithelial neoplasia using 5-aminolevulinic acid.
  • Photodynamic (PDT) therapy is a relatively new technique with unique properties that make it attractive for the local treatment of superficial epithelial disorders.
  • The objective of this study was to investigate the clinical response of PDT with the photosensitizing agent 5-aminolevulinic acid (5-ALA) in patients with vulvar intraepithelial neoplasia (VIN) grades 1 to 3.
  • Twenty-five patients with 111 lesions of VIN 1-3 were topically sensitized with 10 ml of a 20% solution of 5-ALA and treated with 57 cycles of laser light at 635 nm (100 J/cm(2)).
  • Seventy (64%) of the 111 VIN lesions regressed after various PDT cycles.
  • All patients with VIN 1 and mono- and bifocal VIN 2-3 showed complete clearance.
  • However, a complete response could be achieved in only 4 (27%) of 15 women with multifocal VIN 2-3, whereas a partial response was noted in 9 of these patients with a total of 70 lesions, out of which 44 (63%) lesions disappeared.
  • No response was seen in 2 patients with multifocal VIN 3.
  • Histological assessment of the fluorescence-directed biopsies revealed that increased pigmentation and hyperkeratosis of the lesions were associated with low response rates.
  • PDT using 5-ALA represents an alternative treatment modality for VIN which is easy to perform and has the advantage of minimal tissue destruction, low side effects and excellent cosmetic results.
  • However, multifocal VIN disease with pigmented and hyperkeratinic lesions remains difficult to treat.
  • [MeSH-major] Aminolevulinic Acid / therapeutic use. Carcinoma in Situ / drug therapy. Photochemotherapy. Photosensitizing Agents / therapeutic use. Precancerous Conditions / drug therapy. Vulvar Neoplasms / drug therapy

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  • [Copyright] Copyright 2000 Wiley-Liss, Inc.
  • (PMID = 10699944.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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5. Marchitelli C, Secco G, Perrotta M, Lugones L, Pesce R, Testa R: Treatment of bowenoid and basaloid vulvar intraepithelial neoplasia 2/3 with imiquimod 5% cream. J Reprod Med; 2004 Nov;49(11):876-82
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  • [Title] Treatment of bowenoid and basaloid vulvar intraepithelial neoplasia 2/3 with imiquimod 5% cream.
  • OBJECTIVE: To evaluate the effectiveness and safety of imiquimod 5% for the treatment of bowenoid and basaloid vulvar intraepithelial neoplasia (VIN) and to evaluate recurrences following treatment.
  • STUDY DESIGN: Eight patients <55 years old (range, 32-51; mean, 39.7), with bowenoid or basaloid VIN 2/3 diagnosed by biopsy were treated with imiquimod 5%.
  • Women with other types of intraepithelial neoplasia of the lower genital tract, immunosuppressed women, pregnant women and women with other types of vulvar pathology were excluded.
  • Two patients previously treated for VIN 3 (surgical resection, resection by loop electrosurgical excision procedure) had recurrences.
  • Patients applied imiquimod cream 3 times a week until total clearance of the lesions or up to a maximum of 16 weeks.
  • A biopsy was performed at the end of treatment.
  • Two patients had a partial response (1 with 75% and the other with 50% reduction of the lesions).
  • Biopsy was positive for VIN 3 (12.5%) only in the patient showing a clinical response of 50%.
  • Of the 7 patients with biopsies negative for VIN, 2 (25%) were positive for viral infection; 1 gave a negative reading after 2 months after treatment, and the other 1 remained positive for human papillomavirus.
  • The patient with persistent VIN received surgical treatment.
  • No relapses occurred after treatment during 10-30 months of follow-up.
  • CONCLUSION: In this initial series, imiquimod proved to be effective for the treatment of bowenoid and basaloid VIN 2/3 in a group of young women and was less aggressive treatment than surgical ones.
  • The treatment was well tolerated, causing local reactions that enabled the therapy to be completed.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoma in Situ / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Female. Humans. Middle Aged. Papillomavirus Infections / complications. Treatment Outcome

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  • (PMID = 15603097.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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6. Fehr MK, Hornung R, Degen A, Schwarz VA, Fink D, Haller U, Wyss P: Photodynamic therapy of vulvar and vaginal condyloma and intraepithelial neoplasia using topically applied 5-aminolevulinic acid. Lasers Surg Med; 2002;30(4):273-9
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  • [Title] Photodynamic therapy of vulvar and vaginal condyloma and intraepithelial neoplasia using topically applied 5-aminolevulinic acid.
  • BACKGROUND AND OBJECTIVES: To determine the feasibility of photodynamic therapy (PDT) of vulvar and vaginal condyloma and intraepithelial neoplasia (VIN, VAIN) and to compare PDT results with conventional treatments.
  • STUDY DESIGN/MATERIALS AND METHODS: Thirty-eight patients with vulvar or vaginal intraepithelial neoplasia (VIN) grade II/III (n = 22) or condyloma (n = 16) had 10% 5-aminolevulinic acid (ALA)-gel applied topically.
  • PDT was compared to conventional treatments for condyloma (CO(2) laser evaporation) and for VIN III (laser evaporation, surgical excision).
  • Of the neoplasia patients, none with hyperkeratotic VIN (n = 4) responded, and only one of four with increased pigmentation cleared.
  • Reduced disease-free survival (DFS) was associated with multifocal VIN (P = 0.02, OR 2.17, 95% CI 1.15-4.08), but DFS did not vary with treatment mode.
  • CONCLUSIONS: Although PDT is not equally efficacious for all subgroups, PDT for condyloma and intraepithelial neoplasia appears to be as effective as conventional treatments, but with shorter healing time and excellent cosmetic results.
  • [MeSH-major] Aminolevulinic Acid / administration & dosage. Condylomata Acuminata / drug therapy. Photochemotherapy. Photosensitizing Agents / administration & dosage. Precancerous Conditions / drug therapy. Vaginal Diseases / drug therapy. Vaginal Neoplasms / drug therapy. Vulvar Diseases / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adolescent. Adult. Aged. Female. Humans. Laser Therapy. Middle Aged

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  • [Copyright] Copyright 2002 Wiley-Liss, Inc.
  • (PMID = 11948597.001).
  • [ISSN] 0196-8092
  • [Journal-full-title] Lasers in surgery and medicine
  • [ISO-abbreviation] Lasers Surg Med
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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7. McQuillan O, Morgan E: Treatment of vulvar intraepithelial neoplasia using topical imiquimod 5% cream in a genitourinary medicine clinic setting. Int J STD AIDS; 2007 Jan;18(1):63-4
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  • [Title] Treatment of vulvar intraepithelial neoplasia using topical imiquimod 5% cream in a genitourinary medicine clinic setting.
  • In the last five years, options for the treatment of vulvar intraepithelial neoplasia (VIN) have come to include the use of the immune response modifier imiquimod, following case reports of its efficacy in the USA and Europe.
  • Despite topical imiquimod 5% cream being frequently prescribed for the treatment of ano-genital warts, there are no reports of it being used for the treatment of VIN in a genitourinary medicine setting.
  • In this case report self-administered topical imiquimod 5% cream proved an effective treatment for undifferentiated VIN2/3 and should be considered as an alternative therapy in a genitourinary medicine setting.
  • [MeSH-major] Aminoquinolines / administration & dosage. Antineoplastic Agents / administration & dosage. Carcinoma in Situ / drug therapy. Vulvar Neoplasms / drug therapy

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  • (PMID = 17326867.001).
  • [ISSN] 0956-4624
  • [Journal-full-title] International journal of STD & AIDS
  • [ISO-abbreviation] Int J STD AIDS
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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8. Daayana S, Elkord E, Winters U, Pawlita M, Roden R, Stern PL, Kitchener HC: Phase II trial of imiquimod and HPV therapeutic vaccination in patients with vulval intraepithelial neoplasia. Br J Cancer; 2010 Mar 30;102(7):1129-36
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  • [Title] Phase II trial of imiquimod and HPV therapeutic vaccination in patients with vulval intraepithelial neoplasia.
  • BACKGROUND: Vulval intraepithelial neoplasia (VIN) is a premalignant condition, which is frequently associated with type HPV16 infection, and multifocal disease has high rates of surgical treatment failure.
  • METHODS: We report a phase II clinical trial of the topical immunomodulator, imiquimod, for 8 weeks, followed by 3 doses (weeks 10, 14 and 18) of therapeutic human papillomavirus (HPV) vaccination (TA-CIN, fusion protein HPV16 E6E7L2) in 19 women with VIN grades 2 and 3.
  • Intralesional infiltration of T-cell subsets and lymphocyte proliferation for HPV systemic immune responses were also assessed.
  • RESULTS: Lesion response (complete regression of VIN on histology) was observed in 32% (6 out of 19) of women at week 10, increasing to 58% (11 out of 19) at week 20 and 63% (12 out of 19) at week 52.
  • At this time, 36% (5 out of 14) of lesions showed HPV16 clearance and 79% (15 out of 19) of women were symptom free.
  • At week 20, after treatment with imiquimod and vaccination, there was significantly increased local infiltration of CD8 and CD4 T cells in lesion responders; in contrast, non-responders (persistent VIN by histology) showed an increased density of T regulatory cells.
  • CONCLUSION: The therapeutic effect of treatment depends on the differential immune response of responders and non-responders with affect locally and systemically.

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  • (PMID = 20234368.001).
  • [ISSN] 1532-1827
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P50 CA098252; United States / NCI NIH HHS / CA / R01 CA118790; United Kingdom / Cancer Research UK / /
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antigens, Viral; 0 / Cancer Vaccines; 0 / Papillomavirus Vaccines; 99011-02-6 / imiquimod
  • [Other-IDs] NLM/ PMC2853099
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9. Zawislak A, Donnelly RF, McCluggage WG, Price JH, McClelland HR, Woolfson AD, Dobbs S, Maxwell P, McCarron PA: Clinical and immunohistochemical assessment of vulval intraepithelial neoplasia following photodynamic therapy using a novel bioadhesive patch-type system loaded with 5-aminolevulinic acid. Photodiagnosis Photodyn Ther; 2009 Mar;6(1):28-40
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  • [Title] Clinical and immunohistochemical assessment of vulval intraepithelial neoplasia following photodynamic therapy using a novel bioadhesive patch-type system loaded with 5-aminolevulinic acid.
  • BACKGROUND: The work in this study appraised photodynamic treatment (PDT) as a treatment method for vulval intraepithelial neoplasia (VIN) using a novel bioadhesive patch to deliver aminolevulinic acid.
  • An analysis of changes in expression of apoptotic and cell cycle proteins (p53, p21, Mdm2, Blc-2, Bax, Ki-67) in response to PDT was evaluated.
  • METHODS: PDT was performed using non-laser light, either as a one or two-cycle treatment, with clinical and pathological assessment following after 6 weeks.
  • Twenty-three patients with 25 VIN lesions underwent 49 cycles of PDT.
  • Patches were designed to conform to uneven vulval skin and contained 38 mg cm(-2) aminolevulinic acid.
  • Assessment was carried out at 6 weeks post-treatment.
  • Patient-based treatment assessment, along with clinical and pathological changes, were monitored.
  • Changes in expression of cell cycle and apoptotic-related proteins suggested involvement of apoptotic pathways.
  • CONCLUSION: Treatment of VIN lesions using a novel bioadhesive patch induced changes in cell cycle and apoptotic proteins in response to PDT with possible utilisation of apoptotic pathways.
  • The efficacy of PDT in treating VIN could be improved by a better understanding of these apoptotic mechanisms, the influence of factors, such as HPV status, and of the need for effective pain management.
  • [MeSH-major] Aminolevulinic Acid / administration & dosage. Cervical Intraepithelial Neoplasia / drug therapy. Drug Carriers / chemistry. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Aged. Female. Humans. Middle Aged. Photosensitizing Agents / administration & dosage. Tissue Adhesives / chemistry. Treatment Outcome

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  • (PMID = 19447369.001).
  • [ISSN] 1873-1597
  • [Journal-full-title] Photodiagnosis and photodynamic therapy
  • [ISO-abbreviation] Photodiagnosis Photodyn Ther
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Drug Carriers; 0 / Photosensitizing Agents; 0 / Tissue Adhesives; 88755TAZ87 / Aminolevulinic Acid
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10. Campbell SM, Gould DJ, Salter L, Clifford T, Curnow A: Photodynamic therapy using meta-tetrahydroxyphenylchlorin (Foscan) for the treatment of vulval intraepithelial neoplasia. Br J Dermatol; 2004 Nov;151(5):1076-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Photodynamic therapy using meta-tetrahydroxyphenylchlorin (Foscan) for the treatment of vulval intraepithelial neoplasia.
  • BACKGROUND: Photodynamic therapy (PDT) has unique properties which make it suitable for the local treatment of superficial epithelial disorders; it has been suggested as a useful treatment for carcinoma in situ of the vulva.
  • OBJECTIVES: To evaluate the effect of the systemic photosensitizing agent meta-tetrahydroxyphenylchlorin (mTHPC or temoporfin; Foscan, Biolitec, Edinburgh, U.K.) in vulval intraepithelial neoplasia type III (VIN III).
  • METHODS: PDT using mTHPC was performed in six patients with VIN III.
  • A dose of 0.1 mg kg(-1) body weight mTHPC was injected intravenously and the area of VIN irradiated 96 h later with 652-nm light from a diode laser.
  • Patients were reviewed 1 week, 6 months and 2 years following treatment.
  • RESULTS: Patients experienced only minimal pain from the initial treatment but two patients subsequently developed severe pain at the treated site for up to 2 weeks following PDT.
  • All patients developed oedema and slough formation at the treated site and one patient developed cellulitis.
  • At 6 months two patients had developed small recurrences of VIN at the original site and one patient had an area of VIN at a new site.
  • At 2 years there was no recurrence of VIN at the original site in all patients reviewed.
  • CONCLUSIONS: This small case series demonstrates that mTHPC-PDT is a useful initial treatment for VIN III.
  • Repeat treatments are also possible, which is important in a condition such as VIN, which tends to be multifocal.
  • [MeSH-major] Carcinoma in Situ / drug therapy. Mesoporphyrins / therapeutic use. Photochemotherapy / methods. Photosensitizing Agents / therapeutic use. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Adult. Female. Follow-Up Studies. Humans. Middle Aged. Pilot Projects. Treatment Outcome

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  • (PMID = 15541088.001).
  • [ISSN] 0007-0963
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Mesoporphyrins; 0 / Photosensitizing Agents; FU21S769PF / temoporfin
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11. Hillemanns P, Wang X, Staehle S, Michels W, Dannecker C: Evaluation of different treatment modalities for vulvar intraepithelial neoplasia (VIN): CO(2) laser vaporization, photodynamic therapy, excision and vulvectomy. Gynecol Oncol; 2006 Feb;100(2):271-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evaluation of different treatment modalities for vulvar intraepithelial neoplasia (VIN): CO(2) laser vaporization, photodynamic therapy, excision and vulvectomy.
  • OBJECTIVES: To evaluate various treatment modalities for vulvar intraepithelial neoplasia (VIN) in relation to possible risk factors for recurrence.
  • METHODS: Retrospective review of 93 patients with VIN treated by CO(2) laser vaporization, photodynamic therapy with aminolevulinic acid (PDT), excision or vulvectomy.
  • The risk for recurrence significantly increased with VIN grade (P = 0.02), multifocal VIN disease (P = 0.01), multicentric intraepithelial neoplasia (P = 0.05) and high-risk HPV infection (P < 0.001).
  • There was one (1%) case of progression to vulvar cancer.
  • CONCLUSIONS: Vulva preserving treatment methods for VIN have high recurrence rates, especially in patients with HPV infection and multifocal disease.
  • [MeSH-major] Carcinoma in Situ / drug therapy. Carcinoma in Situ / surgery. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / surgery
  • [MeSH-minor] Adult. Aminolevulinic Acid / therapeutic use. Female. Gynecologic Surgical Procedures / methods. Humans. Laser Therapy / methods. Middle Aged. Neoplasm Recurrence, Local. Papillomaviridae. Papillomavirus Infections / complications. Photochemotherapy. Photosensitizing Agents / therapeutic use. Retrospective Studies. Risk Factors. Treatment Outcome

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  • (PMID = 16169064.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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12. Olejek A, Kozak-Darmas I, Biniszkiewicz T, Kellas-Sleczka S, Sieroń A: [Photodynamic therapy in vulvar intraepithelial neoplasia]. Ginekol Pol; 2008 Apr;79(4):276-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Photodynamic therapy in vulvar intraepithelial neoplasia].
  • [Transliterated title] Terapia fotodynamiczna w leczeniu śródnabłonkowej neoplazji sromu.
  • INTRODUCTION: Vulvar intraepithelial neoplasia may lead to vulvar cancer.
  • Vulvar cancer is a rare (accounting for about 2,5-5% of all malignant neoplasms), female genital organs cancer.
  • Photodynamic therapy is a new treatment for a wide variety of malignancies and premalignant dysplasias.
  • We wanted to examine the effectiveness of photodynamic therapy (PDT) on vulvar intraepithelial neoplasia (VIN).
  • DESIGN: The aim of the study was to analyze the effectiveness of photodynamic therapy (PDT) on vulvar intraepithelial neoplasia (VIN).
  • MATERIAL AND METHODS: We have analyzed 20 women with VIN, who were treated in our center - Clinic of Vulvar Diseases.
  • All these women had photodynamic diagnosis (PDD), photodynamic therapy followed (PDT), with 5% ALA applied to the entire vulva.
  • [MeSH-major] Aminolevulinic Acid / administration & dosage. Carcinoma in Situ / drug therapy. Photochemotherapy / methods. Photosensitizing Agents / administration & dosage. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Humans. Laser Therapy. Middle Aged. Poland. Treatment Outcome

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  • (PMID = 18592866.001).
  • [ISSN] 0017-0011
  • [Journal-full-title] Ginekologia polska
  • [ISO-abbreviation] Ginekol. Pol.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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13. Todd RW, Luesley DM: Medical management of vulvar intraepithelial neoplasia. J Low Genit Tract Dis; 2005 Oct;9(4):206-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Medical management of vulvar intraepithelial neoplasia.
  • OBJECTIVE: To determine which nonsurgical treatments have been assessed for the treatment of vulvar intraepithelial neoplasia (VIN) and what the outcomes of such treatment might be.
  • RESULTS: A wide variety of nonsurgical treatments was identified and the outcomes were very similar.
  • These treatments showed responses rates varying between 10% and 60%.
  • CONCLUSIONS: Although VIN is a condition in which there would seem to be a pressing need for nonsurgical interventions, none of the nonsurgical treatments reviewed resulted in optimal outcomes.
  • No one treatment seemed to be superior.
  • Because VIN is uncommon, there is a strong case for establishing research collaboratives.
  • [MeSH-major] Carcinoma in Situ / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Antineoplastic Agents / therapeutic use. Female. Humans. Photochemotherapy. Retinoids / therapeutic use. Treatment Outcome. Vaccination

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  • (PMID = 16205189.001).
  • [ISSN] 1089-2591
  • [Journal-full-title] Journal of lower genital tract disease
  • [ISO-abbreviation] J Low Genit Tract Dis
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Antineoplastic Agents; 0 / Retinoids
  • [Number-of-references] 40
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14. van Seters M, Fons G, van Beurden M: Imiquimod in the treatment of multifocal vulvar intraepithelial neoplasia 2/3. Results of a pilot study. J Reprod Med; 2002 Sep;47(9):701-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Imiquimod in the treatment of multifocal vulvar intraepithelial neoplasia 2/3. Results of a pilot study.
  • OBJECTIVE: To investigate the efficacy of topical treatment with imiquimod 5% cream, an immune response modifier, in patients with vulvar intraepithelial neoplasia (VIN) 2/3.
  • STUDY DESIGN: Fifteen women (aged 35-51) with histologically proven multifocal VIN 2/3 without invasion, were entered into a prospective, observational, pilot study.
  • Imiquimod 5% cream was applied by the patient to the vulvar lesions one to three times a week at night.
  • RESULTS: Four patients achieved CR (27%) and nine patients, PR (60%) after 6-34 weeks of treatment.
  • Two patients discontinued medication.
  • CR was reached after 6, 7, 11 and 30 weeks of treatment.
  • CONCLUSION: This pilot study showed the potential beneficial effect of imiquimod 5% cream in multifocal VIN 2/3.
  • In contrast to current surgical treatment, imiquimod focuses on the cause of VIN and preserves the anatomy and function of the vulva.
  • Therefore, imiquimod may prove to be the treatment of choice in multifocal, high grade VIN.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoma in Situ / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Female. Humans. Middle Aged. Neoplasm Staging. Pilot Projects. Prospective Studies. Time Factors. Vaginal Creams, Foams, and Jellies

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  • (PMID = 12380448.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 0 / Vaginal Creams, Foams, and Jellies; 99011-02-6 / imiquimod
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15. Le T, Hicks W, Menard C, Hopkins L, Fung MF: Preliminary results of 5% imiquimod cream in the primary treatment of vulva intraepithelial neoplasia grade 2/3. Am J Obstet Gynecol; 2006 Feb;194(2):377-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preliminary results of 5% imiquimod cream in the primary treatment of vulva intraepithelial neoplasia grade 2/3.
  • OBJECTIVE: This study was undertaken to study the tolerability and efficacy of 5% imiquimod cream in the primary treatment of vulva intraepithelial neoplasia (VIN) grade 2/3.
  • STUDY DESIGN: VIN grade 2/3 patients were recruited from regional colposcopy units.
  • Imiquimod cream was applied over the abnormal area by the patient using an escalating dose regime for total treatment duration of 16 weeks.
  • Twenty patients (87%) had VIN grade 3.
  • Therapy was well tolerated with the most commonly observed side effects being irritation at the application site.
  • The median time to response was 7 weeks.
  • CONCLUSION: Imiquimod cream can induce histologic regression of high-grade VIN lesions and is well tolerated using a slow dose-escalating regime.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Carcinoma in Situ / drug therapy. Vulvar Neoplasms / drug therapy

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  • (PMID = 16458632.001).
  • [ISSN] 1097-6868
  • [Journal-full-title] American journal of obstetrics and gynecology
  • [ISO-abbreviation] Am. J. Obstet. Gynecol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 99011-02-6 / imiquimod
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16. Fehr MK, Hornung R, Schwarz VA, Simeon R, Haller U, Wyss P: Photodynamic therapy of vulvar intraepithelial neoplasia III using topically applied 5-aminolevulinic acid. Gynecol Oncol; 2001 Jan;80(1):62-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Photodynamic therapy of vulvar intraepithelial neoplasia III using topically applied 5-aminolevulinic acid.
  • OBJECTIVES: The aim of this study was twofold: first, to determine the feasibility of photodynamic therapy (PDT) of vulvar intraepithelial neoplasia III (VIN III) using topically applied 5-aminolevulinic acid (ALA) for photosensitization, and second, to compare PDT results with those of laser evaporation and local excision.
  • METHODS: Fifteen patients with VIN III had 10 g of 10% ALA gel applied to the entire vulva.
  • Two to three hours after drug application the vulva was irradiated with 120 J/cm(2) laser light at a wavelength of 635 nm.
  • The procedure was performed without anesthesia in most patients.
  • Thirty patients with VIN III treated by laser evaporation and 27 patients treated by surgical excision served as controls.
  • RESULTS: Eight weeks following PDT, 11 of 15 patients were free of VIN III as determined by biopsy.
  • Excellent tissue preservation was achieved and no ulcers or scarring occurred.
  • Twelve months after treatment, analysis of disease-free survival revealed no statistically significant difference between patients treated with PDT and patients treated with conventional treatment modalities (P = 0.67) but the power of this analysis is low.
  • CONCLUSION: While PDT of VIN III seems to show efficacy similar to that of conventional treatment modalities it offers unique advantages: healing time is short, preservation of normal vulvar appearance is excellent, and PDT may be performed without anesthesia.
  • Hence, PDT of VIN III deserves further investigation.
  • [MeSH-major] Aminolevulinic Acid / administration & dosage. Carcinoma in Situ / drug therapy. Photochemotherapy. Photosensitizing Agents / administration & dosage. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Disease-Free Survival. Feasibility Studies. Female. Gels. Humans. Laser Therapy. Middle Aged. Multivariate Analysis

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  • [Copyright] Copyright 2001 Academic Press.
  • [CommentIn] Gynecol Oncol. 2002 Jan;84(1):187-9 [11749005.001]
  • (PMID = 11136571.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Gels; 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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17. Kurwa HA, Barlow RJ, Neill S: Single-episode photodynamic therapy and vulval intraepithelial neoplasia type III resistant to conventional therapy. Br J Dermatol; 2000 Nov;143(5):1040-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Single-episode photodynamic therapy and vulval intraepithelial neoplasia type III resistant to conventional therapy.
  • BACKGROUND: Photodynamic therapy (PDT) using topical 5-aminolaevulinic acid (5-ALA) has been suggested as an effective and tissue-conserving method of treating carcinoma in situ of the vulva.
  • OBJECTIVES: To evaluate PDT in patients with vulval intraepithelial neoplasia type III (VIN III).
  • METHODS: Topical PDT was performed in six patients with VIN III.
  • Five of the six patients had persistent disease following treatment with other modalities including 5-fluorouracil cream, cryotherapy, carbon dioxide laser ablation and excision.
  • Patients were reviewed clinically at 1 month and 6 months after treatment.
  • RESULTS: All of the patients developed initial erythema of treated sites, three with subsequent erosions.
  • All patients had clinically evident persistent VIN III at 1-month review.
  • Five patients have subsequently undergone surgical treatment and one is regularly reviewed.
  • CONCLUSIONS: This small uncontrolled study indicates that, as currently administered, a single episode of topical PDT is not effective in the management of treatment-resistant VIN III.
  • [MeSH-major] Carcinoma in Situ / drug therapy. Photochemotherapy / methods. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aminolevulinic Acid / therapeutic use. Female. Humans. Photosensitizing Agents / therapeutic use. Pilot Projects. Treatment Failure

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  • (PMID = 11069517.001).
  • [ISSN] 0007-0963
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 88755TAZ87 / Aminolevulinic Acid
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18. Jayne CJ, Kaufman RH: Treatment of vulvar intraepithelial neoplasia 2/3 with imiquimod. J Reprod Med; 2002 May;47(5):395-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of vulvar intraepithelial neoplasia 2/3 with imiquimod.
  • OBJECTIVE: To retrospectively review the charts of 13 women diagnosed with vulvar intraepithelial neoplasia (VIN) 2/3 treated with imiquimod and to evaluate the efficacy of this treatment.
  • The extent of the lesions prior to treatment and the extent and degree of improvement were documented.
  • Response to treatment was categorized as complete regression, at least 75% regression or not improved.
  • RESULTS: The mean duration of treatment was 3.3 months, and follow-up after completion of therapy was 5.5 months.
  • Eight of the 13 women had complete regression of the VIN.
  • In two women demonstrating 75% lesion regression, invasive carcinoma of the vulva was found in the area of residual disease.
  • In one instance this was determined to be superficially invasive squamous cell carcinoma (1 mm of invasion), and in the second an anal tag was found to have invasive squamous cell carcinoma.
  • CONCLUSION: Medical management of VIN 2/3 with imiquimod is worth considering.
  • However, careful evaluation of the patient must be carried out prior to the institution of therapy to exclude the presence of invasive squamous cell carcinoma.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoma in Situ / drug therapy. Neoplasm Recurrence, Local / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Cutaneous. Adult. Aged. Disease-Free Survival. Female. Humans. Medical Records. Middle Aged. Retrospective Studies. Texas. Treatment Outcome

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  • (PMID = 12063878.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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19. Mahto M, Nathan M, O'Mahony C: More than a decade on: review of the use of imiquimod in lower anogenital intraepithelial neoplasia. Int J STD AIDS; 2010 Jan;21(1):8-16
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] More than a decade on: review of the use of imiquimod in lower anogenital intraepithelial neoplasia.
  • To assess the effectiveness of 5% imiquimod cream (IQ) in the treatment of vulvar, penile and anal intraepithelial neoplasias (VIN, PIN and AIN), we searched Medline, Embase, PubMed and Cochrane Library databases.
  • With regard to VIN there were two randomized controlled trials (RCTs), eight uncontrolled/cohort studies, nine case reports and one review article.
  • On pooled analysis of RCTs, uncontrolled and cohort studies, the mean complete response (CR) rate for VIN, PIN and AIN were 51%, 70% and 48%, respectively.
  • The mean partial response (PR) rate for VIN, PIN and AIN were 25%, 30% and 34% respectively.
  • The recurrence (RR) rate for VIN, PIN and AIN were 16%, 0% and 36%, respectively.
  • The follow-up period for VIN, PIN and AIN ranged from 2 to 32 months, 10 to 12 months and 11 to 39 months, respectively.
  • Although the results for PIN look the best, the strongest evidence regarding efficacy of IQ in anogenital intraepithelial neoplasia is for VIN supported by RCTs.
  • IQ was reasonably well tolerated with side-effects being managed with reduction in frequency of drug usage and/or rest periods.
  • Based on these results, IQ seems to be a safe mode of treatment and is possibly an alternative to currently available methods of treatment.
  • However, there are no comparative studies assessing its efficacy against traditional modes of treatment.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma in Situ / drug therapy. Penile Neoplasms / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Aged. Female. HIV Infections / complications. Humans. Male. Middle Aged. Randomized Controlled Trials as Topic. Treatment Outcome

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  • (PMID = 20029061.001).
  • [ISSN] 0956-4624
  • [Journal-full-title] International journal of STD & AIDS
  • [ISO-abbreviation] Int J STD AIDS
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
  • [Number-of-references] 69
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20. Davis G, Wentworth J, Richard J: Self-administered topical imiquimod treatment of vulvar intraepithelial neoplasia. A report of four cases. J Reprod Med; 2000 Aug;45(8):619-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Self-administered topical imiquimod treatment of vulvar intraepithelial neoplasia. A report of four cases.
  • BACKGROUND: Vulvar intraepithelial neoplasia (VIN) generally can be classified into viral and nonviral etiologies.
  • The histopathologic diagnosis is often separable into basaloid and warty types.
  • A large percentage of VIN lesions have been shown to harbor human papillomavirus (HPV), principally type 16.
  • Imiquimod, an immune response modifier, has been shown to be safe and effective for the treatment of external and perianal genital warts caused by HPV.
  • CASES: Four cases occurred of clinical and histopathologically diagnosed viral VIN 3.
  • An imiquimod treatment protocol, previously used in a study of this drug for the treatment of external genital warts, was followed.
  • Imiquimod 5% cream was patient applied three times per week until all lesions cleared, for a maximum of 16 weeks.
  • CONCLUSION: Imiquimod may be an effective treatment modality for viral VIN 3 in the future.
  • [MeSH-major] Adjuvants, Immunologic / administration & dosage. Aminoquinolines / administration & dosage. Carcinoma in Situ / drug therapy. Tumor Virus Infections / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Cutaneous. Adult. Condylomata Acuminata / drug therapy. Condylomata Acuminata / virology. Drug Administration Schedule. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / virology. Ointments. Papillomaviridae / isolation & purification. Self Administration

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  • (PMID = 10986679.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 0 / Ointments; 99011-02-6 / imiquimod
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21. Todd RW, Etherington IJ, Luesley DM: The effects of 5% imiquimod cream on high-grade vulval intraepithelial neoplasia. Gynecol Oncol; 2002 Apr;85(1):67-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The effects of 5% imiquimod cream on high-grade vulval intraepithelial neoplasia.
  • OBJECTIVES: The aim of this study was to investigate the effects of topical 5% Imiquimod (3M Pharmaceuticals, St. Paul, Minnessota) on high-grade vulval intraepithelial neoplasia (VIN).
  • Fifteen patients with histologically confirmed VIN 3 were asked to self-administer 5% Imiquimod cream to their vulval lesions up to three times weekly for 16 weeks.
  • Local side effects limited the frequency of application such that 7 patients applied the cream once weekly, 6 twice weekly, and 2 three times weekly.
  • CONCLUSIONS: 5% Imiquimod cream appears to have an effect when used on high-grade VIN.
  • [MeSH-major] Aminoquinolines / administration & dosage. Antineoplastic Agents / administration & dosage. Precancerous Conditions / drug therapy. Vulvar Neoplasms / drug therapy

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  • (PMID = 11925122.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 0 / Ointments; 99011-02-6 / imiquimod
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22. Mathiesen O, Buus SK, Cramers M: Topical imiquimod can reverse vulvar intraepithelial neoplasia: a randomised, double-blinded study. Gynecol Oncol; 2007 Nov;107(2):219-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Topical imiquimod can reverse vulvar intraepithelial neoplasia: a randomised, double-blinded study.
  • OBJECTIVE: To investigate the effect of topical imiquimod in patients with vulvar intraepithelial neoplasia (VIN).
  • RESULTS: Thirty-two patients were included, one was excluded before treatment.
  • Twenty-one received active treatment, 10 received placebo.
  • Seventeen (81%) in the treatment group showed complete response, two (10%) partial response and none responded in the placebo-group when evaluated by a biopsy 2 months after a treatment period of 16 weeks.
  • Fourteen of 21 patients (67%) in the treatment group had to reduce the number of applications due to local side-effects.
  • CONCLUSION: The topical treatment with imiquimod 5% was shown in this setting to be very efficient.
  • [MeSH-major] Adjuvants, Immunologic / administration & dosage. Aminoquinolines / administration & dosage. Antineoplastic Agents / administration & dosage. Carcinoma in Situ / drug therapy. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Aged. Double-Blind Method. Female. Humans. Middle Aged. Pain / chemically induced. Prospective Studies. Treatment Outcome

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  • [CommentIn] Gynecol Oncol. 2008 Jun;109(3):430-1; author reply 431 [18295871.001]
  • (PMID = 17655918.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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23. Naik R, Nixon S, Lopes A, Godfrey K, Hatem MH, Monaghan JM: A randomized phase II trial of indole-3-carbinol in the treatment of vulvar intraepithelial neoplasia. Int J Gynecol Cancer; 2006 Mar-Apr;16(2):786-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A randomized phase II trial of indole-3-carbinol in the treatment of vulvar intraepithelial neoplasia.
  • The aim of this study was to determine the potential therapeutic benefits of indole-3-carbinol (I3C) in the management of vulvar intraepithelial neoplasia (VIN).
  • Women with histologically confirmed high-grade VIN were randomized to receive 200 and 400 mg/day of I3C.
  • Tissue biopsy to determine histologic response was obtained at completion of the study period.
  • However, tissue biopsy from the worst-affected vulval areas revealed no improvement in grade of VIN during the 6-month period, P= 0.317.
  • This study has shown significant clinical improvement in symptomatology and vulvoscopic appearance of VIN with I3C therapy.
  • [MeSH-major] Carcinoma in Situ / drug therapy. Carcinoma, Squamous Cell / drug therapy. Indoles / therapeutic use. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Disease-Free Survival. Female. Humans. Hydroxyestrones / metabolism. Middle Aged. Neoplasm Staging. Survival Rate. Treatment Outcome

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  • (PMID = 16681761.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hydroxyestrones; 0 / Indoles; 18186-49-7 / 16-hydroxyestrone; C11E72455F / indole-3-carbinol; UQS3A06ILY / 2-hydroxyestrone
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24. Wendling J, Saiag P, Berville-Levy S, Bourgault-Villada I, Clerici T, Moyal-Barracco M: Treatment of undifferentiated vulvar intraepithelial neoplasia with 5% imiquimod cream: a prospective study of 12 cases. Arch Dermatol; 2004 Oct;140(10):1220-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of undifferentiated vulvar intraepithelial neoplasia with 5% imiquimod cream: a prospective study of 12 cases.
  • OBJECTIVE: To assess the efficacy of 5% imiquimod cream on undifferentiated vulvar intraepithelial neoplasia (VIN), a disease caused by high-risk human papillomavirus.
  • SETTING: University hospital vulvar clinic.
  • Patients Twelve consecutive patients treated with 5% imiquimod cream for undifferentiated VIN between March 1, 1999, and May 31, 2001.
  • INTERVENTION: Self-application of 5% imiquimod cream, initially 3 times a week, then adjusted according to tolerance, for up to 7 months according to clinical response.
  • MAIN OUTCOME MEASURES: Therapeutic response, clinically assessed by successive photographs and histologically confirmed for complete responders, was scored as complete, partial (> or =50% decrease in lesion size), or failure.
  • Mean duration of treatment was 3.6 months (37.3 applications), 5.0 months (50.7 applications), and 3.4 months (25.2 applications) for complete responders, partial responders, and failures, respectively.
  • Follow-up after treatment was 5 to 18, 14 to 32, and 2 to 28 months, respectively, with 1 partial responder lost to long-term follow-up.
  • No patient developed invasive carcinoma.
  • All but 2 patients experienced vulvar discomfort, resulting in treatment withdrawal for 3.
  • CONCLUSIONS: Imiquimod cream could be a therapeutic option for undifferentiated VIN.
  • Although poorly tolerated, this self-applied treatment could spare patients, either totally or partially, the classic painful and sometimes mutilating treatments of VIN.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Cutaneous. Adult. Female. Humans. Middle Aged. Papillomaviridae. Precancerous Conditions / drug therapy. Precancerous Conditions / pathology. Precancerous Conditions / virology. Prospective Studies. Treatment Outcome

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  • (PMID = 15492184.001).
  • [ISSN] 0003-987X
  • [Journal-full-title] Archives of dermatology
  • [ISO-abbreviation] Arch Dermatol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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25. Le T, Menard C, Hicks-Boucher W, Hopkins L, Weberpals J, Fung-Kee-Fung M: Final results of a phase 2 study using continuous 5% Imiquimod cream application in the primary treatment of high-grade vulva intraepithelial neoplasia. Gynecol Oncol; 2007 Sep;106(3):579-84
Hazardous Substances Data Bank. Imiquimod .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Final results of a phase 2 study using continuous 5% Imiquimod cream application in the primary treatment of high-grade vulva intraepithelial neoplasia.
  • OBJECTIVES: To investigate the activity of 5% Imiquimod cream in the primary treatment of vulva intraepithelial neoplasia (VIN) grade 2/3.
  • METHODS: Patients with histologically confirmed VIN 2/3 were recruited from regional colposcopy units.
  • Imiquimod cream was applied over the abnormal VIN areas by the patients, using an escalating dose regimen for a total treatment duration of 16 weeks.
  • A historical cohort of VIN 2/3 patients treated with primary surgical ablation was used to compare recurrence patterns.
  • Thirty-six patients (92%) had VIN 3.
  • Therapy was well tolerated with the most common observed side effects being only minor skin irritation at the application site.
  • No VIN progression or cancer was diagnosed.
  • CONCLUSION: Imiquimod cream was well tolerated and resulted in the regression in a majority of high-grade VIN lesions.
  • [MeSH-major] Aminoquinolines / administration & dosage. Antineoplastic Agents / administration & dosage. Carcinoma in Situ / drug therapy. Vulvar Neoplasms / drug therapy

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  • (PMID = 17582474.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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26. Olejek A, Rembielak-Stawecka B, Kozak-Darmas I, Biniszkiewicz T, Sieroń A: [Photodynamic diagnosis and therapy in gynecology--current knowledge]. Ginekol Pol; 2004 Mar;75(3):228-34
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Photodynamic diagnosis and therapy in gynecology--current knowledge].
  • [Transliterated title] Diagnostyka i terapia fotodynamiczna w ginekologii--aktualny stan wiedzy.
  • Photodynamic diagnosis (PDD) is a new method based on the detection of different forms of fluorescence of tissues after previous administration of photosensitizers.
  • The photosensitizer is gathered in the pathological tissue at much higher concentration than in the healthy tissue, thus the fluorescence differs.
  • Localizing wrong fluorescence allows precise choosing of the spot to collect tissue for histopathological or cytological study.
  • Photodynamic therapy (PDT) is a technique in which tissue is irradiated with light after the use of a photosensitizing drug that produces singlet oxygen, which has a cytotoxic effect.
  • The authors describe new trends in photodynamic diagnosis and treatment of some vulvar epithelial diseases (VIN, lichen sclerosus, condylomata acuminata) and cervical intraepithelial neoplasia.
  • They describe photodynamic method in their own studies: diagnosis and treatment of lichen sclerosus and diagnosis of uterine cervix cancer.
  • [MeSH-major] Diagnostic Techniques, Obstetrical and Gynecological. Photochemotherapy. Photosensitizing Agents / therapeutic use. Vulvar Diseases / diagnosis. Vulvar Diseases / drug therapy
  • [MeSH-minor] Cervical Intraepithelial Neoplasia / diagnosis. Cervical Intraepithelial Neoplasia / drug therapy. Condylomata Acuminata / diagnosis. Condylomata Acuminata / drug therapy. Female. Humans. Lichen Sclerosus et Atrophicus / diagnosis. Lichen Sclerosus et Atrophicus / drug therapy. Precancerous Conditions / diagnosis. Precancerous Conditions / drug therapy. Tumor Virus Infections / diagnosis. Tumor Virus Infections / drug therapy. Vulvar Neoplasms / diagnosis

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  • (PMID = 15181882.001).
  • [ISSN] 0017-0011
  • [Journal-full-title] Ginekologia polska
  • [ISO-abbreviation] Ginekol. Pol.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Photosensitizing Agents
  • [Number-of-references] 30
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27. Todd RW, Steele JC, Etherington I, Luesley DM: Detection of CD8+ T cell responses to human papillomavirus type 16 antigens in women using imiquimod as a treatment for high-grade vulval intraepithelial neoplasia. Gynecol Oncol; 2004 Jan;92(1):167-74
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Detection of CD8+ T cell responses to human papillomavirus type 16 antigens in women using imiquimod as a treatment for high-grade vulval intraepithelial neoplasia.
  • OBJECTIVES: To investigate CD8+ T cell reactivity to human papillomavirus (HPV) 16 antigens in patients with high-grade vulval intraepithelial neoplasia (VIN) before, during and after treatment with 5% imiquimod cream.
  • METHODS: CD8-enriched responder cell populations were obtained from 10 patients with high-grade VIN using imiquimod cream as a treatment.
  • Overlapping synthetic peptides covering the entire primary sequences of the HPV16 E6, E7 and E4 proteins were used to screen for CD8+ T cell responses using an ELISPOT assay of interferon (IFN)-gamma release.
  • With the exception of one patient, CD8+ T cell reactivity generally increased at some stage during treatment.
  • The magnitude and specificities of responses changed over the treatment period.
  • CD8+ T cell reactivity to HPV16 E7 appeared to be dominant amongst women with high-grade VIN.
  • CONCLUSIONS: HPV16 specific CD8+ T cell activity was detected in patients with high-grade VIN.
  • Despite the presence of these CD8+ T cells, the disease state persisted; therefore, a role for HPV-specific cytotoxic T cells (CTLs) in VIN resolution remains unproven.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antigens, Viral, Tumor / immunology. Antineoplastic Agents / therapeutic use. CD8-Positive T-Lymphocytes / immunology. Papillomaviridae / immunology. Repressor Proteins. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / immunology

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  • (PMID = 14751153.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antibodies, Viral; 0 / Antigens, Viral, Tumor; 0 / Antineoplastic Agents; 0 / DNA, Viral; 0 / E6 protein, Human papillomavirus type 16; 0 / Oncogene Proteins, Viral; 0 / Papillomavirus E7 Proteins; 0 / Repressor Proteins; 0 / oncogene protein E4, Human papillomavirus type 16; 0 / oncogene protein E7, Human papillomavirus type 16; 82115-62-6 / Interferon-gamma; 99011-02-6 / imiquimod
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