Ashkenazy Noy, Karp Carol L, Wang Gaofeng, Acosta Carolina Mercado, Galor Anat
*Department of Ophthalmology, Miami Veterans Affairs Medical Center; †Bascom Palmer Eye Institute, University of Miami, Miami, FL; and ‡Jackson Memorial Hospital, Miami, FL.
Cornea. 2017 Apr;36(4):506-510. doi: 10.1097/ICO.0000000000001153.
The mechanism by which ocular surface squamous neoplasia (OSSN) responds to topical interferon-alpha-2b (IFNα2b) is not known. We report the cases of 3 immunosuppressed patients whose tumors did not respond to topical IFNα2b therapy. The purpose of this series is to shed light on potential mechanisms of IFNα2b in OSSN.
Retrospective case series of 3 immunosuppressed patients whose biopsy-proven OSSN did not respond to topical IFNα2b treatment.
Three white, immunosuppressed males (mean age 70 years, range 66-76) were diagnosed with OSSN. Topical IFNα2b 1 million units/mL was administered 4 times a day and used for a mean of 5 months (range 2-7 mo) without an adequate response. All patients were then switched to 5-fluorouracil. Successful eradication of OSSN was achieved in 2 cases, and improvement of OSSN in another. The latter patient was switched to mitomycin-C with subsequent resolution of OSSN.
These cases suggest that an intact immune system may be an important link between IFNα2b therapy and tumor resolution. As such, topical IFNα2b may not be an optimal choice for patients with underlying immunosuppression. It may be more effective in this patient population to switch to a non-immune-modulating therapy such as 5-fluorouracil or mitomycin-C.
眼表鳞状上皮瘤变（OSSN）对局部应用干扰素-α-2b（IFNα2b）的反应机制尚不清楚。我们报告了3例免疫抑制患者的病例，他们的肿瘤对局部IFNα2b治疗无反应。本系列病例的目的是阐明IFNα2b在OSSN中的潜在作用机制。
对3例经活检证实的OSSN且对局部IFNα2b治疗无反应的免疫抑制患者进行回顾性病例系列研究。
3例白人免疫抑制男性（平均年龄70岁，范围66 - 76岁）被诊断为OSSN。局部应用100万单位/毫升的IFNα2b，每天4次，平均使用5个月（范围2 - 7个月），但未获得充分反应。所有患者随后改用5-氟尿嘧啶。2例患者成功根除OSSN，另1例患者病情有所改善。后1例患者改用丝裂霉素-C，随后OSSN得到缓解。
这些病例表明，完整的免疫系统可能是IFNα2b治疗与肿瘤消退之间的重要联系。因此，对于存在潜在免疫抑制的患者，局部应用IFNα2b可能不是最佳选择。对于这类患者，改用如5-氟尿嘧啶或丝裂霉素-C等非免疫调节疗法可能更有效。
