Imiquimod Cream Effective for Melanoma Positive Margins

This study examined the effectiveness of using 5% topical imiquimod cream to treat positive surgical margins after removing melanoma, a type of skin cancer. The researchers aimed to determine if this treatment could be a safe and effective alternative to additional surgery for clearing cancerous cells left at the edges of removed tissue.

Melanoma is a serious form of skin cancer with rising cases globally. Traditional treatment involves surgically removing the cancer with a margin of healthy tissue to ensure no cancer cells remain. However, achieving clear margins can be challenging, especially in sensitive areas like the face. This study's exploration of imiquimod, an immune-boosting cream, offers a potential non-surgical option, which could reduce the need for further invasive procedures and improve patient outcomes.

The researchers conducted a retrospective review of patient records from the Yale Melanoma Registry, covering cases from 2008 to 2021. They focused on patients with positive margins after melanoma surgery who were treated with imiquimod. The study included data on patient demographics, treatment duration, responses, complications, and follow-up times. Patients applied the cream up to five times a week for four to 12 weeks, with treatment tailored based on their response.

Out of 64 patients treated with imiquimod, 84% showed no evidence of melanoma in follow-up biopsies. The median treatment duration was 12 weeks. Six patients experienced cancer recurrence, and three developed metastatic disease. Side effects were generally mild, with some patients experiencing fatigue or flu-like symptoms. Notably, patients with stronger inflammatory reactions to the cream tended to have better outcomes

The findings suggest that imiquimod can be a viable alternative to additional surgery for patients with positive melanoma margins. This treatment could be particularly beneficial for patients in cosmetically sensitive areas, offering a less invasive option with a high success rate. The degree of skin reaction may also help predict treatment success, guiding clinicians in tailoring therapy.

The authors recommend further research to establish standardized treatment protocols for imiquimod use in melanoma cases. Future studies could explore the combination of imiquimod with other therapies to enhance effectiveness and investigate the long-term outcomes of this treatment approach.

This research was supported by Yale University.