Kibbi Nour, Ariyan Stephan, Faries Mark, Choi Jennifer N
Departments of *Dermatology †Surgery, Yale University School of Medicine, New Haven, CT ‡John Wayne Cancer Institute, Santa Monica, CA.
J Immunother. 2015 Nov-Dec;38(9):371-5. doi: 10.1097/CJI.0000000000000098.
Local therapy for in-transit melanoma (ITM) is a treatment alternative for patients who are not good candidates for systemic therapy, regional therapy, or surgical management. In this case report, we describe 3 patients with ITM who were treated with intralesional Bacillus Calmette-Guérin (ILBCG) and/or topical imiquimod. Treatment course was dictated by the clinical response. Patient 1's response to ILBCG monotherapy was not sufficient to cause disease regression; however, transition to topical imiquimod therapy resulted in complete and sustained response. Although patient 2 responded to ILBCG and imiquimod, she developed a hypersensitivity reaction to ILBCG; when topical imiquimod was continued as monotherapy, her clinical response was complete. Patient 3 responded completely to ILBCG monotherapy in injected lesions, but expired shortly thereafter from unrelated disease. Reports like this one are needed to define the success measures of local therapy in the treatment of ITM.
对于无法接受全身治疗、区域治疗或手术治疗的患者，局部治疗是治疗皮肤转移黑素瘤（ITM）的一种替代方法。在本病例报告中，我们描述了3例接受皮损内卡介苗（ILBCG）和/或外用咪喹莫特治疗的ITM患者。治疗过程根据临床反应而定。患者1对ILBCG单一疗法的反应不足以使疾病消退；然而，改用外用咪喹莫特治疗后产生了完全且持续的反应。虽然患者2对ILBCG和咪喹莫特均有反应，但她对ILBCG产生了超敏反应；当继续单独使用外用咪喹莫特治疗时，她的临床反应完全。患者3对注射病灶的ILBCG单一疗法完全反应，但此后不久因无关疾病死亡。需要更多这样的报告来确定局部治疗在ITM治疗中的成功标准。
