Abstract
Background
Current treatments for in-transit melanoma (ITM) metastases are frequently invasive and do not improve overall survival. Recently there has been increasing investigation into the use of topical agents for ITM. Diphenylcyclopropenone or diphencyprone (DPCP) is a novel, topical agent that has been reported to have immune-sensitising properties useful in the treatment of ITM.
Objective
To assess the clinical outcomes of patients treated within a prospective, non-randomised, non-comparative study using DPCP for cutaneous in-transit melanoma metastases.
Methods
A review was conducted assessing the outcomes of 58 patients prospectively treated using DPCP. Patients had satellite or in-transit disease (stage IIIB+), with all lesion morphology types included. The patients were treated through a single, specialised clinic with regular outpatient follow-up. DPCP was topically applied as an aqueous cream in 0.005% - 1% concentrations once to twice per week for up to 24 - 48 hours duration. To assess variables associated with response, a per-protocol statistical analysis was performed.
Results
Fifty-four patients were treated who satisfied eligibility criteria for analysis. The overall response rates were: complete response 22%, partial response 39%, stable disease 24% and progressive disease 15%. The mean time to CR was 10.5 months, mean duration of CR (disease-free interval) 12.3 months and recurrence rate in complete responders 41.2%. Lesion morphology was predictive of clinical benefit with a higher response in epidermotropic disease (P <0.05).
Conclusions
DPCP provided a well-tolerated, convenient and efficacious treatment for cutaneous in-transit melanoma metastases. Identifying patterns of response may assist treatment selection and improve patient-rated outcomes.
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