Topical Cream Treats Precancerous Lesions of Vulva

(Page 2)

Depending on the severity of the disease, the cancer society noted that current treatment options range from laser surgery to invasive and often repeated surgery to remove all or part of the vulva. Groin lymph node removal, radiation and chemotherapy are additional options.

Seters and her team explored the potential for the cream treatment among 52 women already diagnosed with the precancerous condition.

All the women sought care at Erasmus or at a second facility in Amsterdam between 2001 and 2003, and all were over the age of 18, sexually active, and premenopausal. The majority had grade 3 disease, while none had a history of vulvar cancer.

Half were randomly assigned to receive 250 milligrams of imiquimod 5 percent, while the other half was given a placebo cream. The creams were applied to lesions in a thin layer twice a week for 16 weeks.

By the end of treatment, about four in five of the imiquimod patients experienced a reduction in lesion size of more than 25 percent. None of the placebo patients saw their lesions shrink to this degree.

Lesion reduction of more than 75 percent occurred in five imiquimod patients, and lesions completely disappeared in nine imiquimod patients. These women remained lesion-free one year later. Eight imiquimod patients were determined to be completely free of the disease both at treatment end and one year after.

As well, 15 imiquimod patients were found to be clear of HPV immediately following treatment, compared with just two placebo patients.

Even among those still battling the lesions post-treatment, almost 70 percent of the imiquimod patients saw their disease severity drop from grade 3 to grade 2. This was the case in only one placebo patient.

Imiquimod appeared to improve quality of life as well, as severe itching and pain was lower among treated patients than placebo patients both right after treatment and one year later.

Seters and her colleagues say they still must map out the exact mechanics behind the cream's impact, while exploring why some patients benefited while others did not. Nevertheless, they concluded that the cream should be considered the "first-choice treatment" for these lesions.