TY - JOUR
T1 - Topical Imiquimod Treatment of High-grade Cervical Intraepithelial Neoplasia (TOPIC-3)
T2 - A Nonrandomized Multicenter Study
AU - Hendriks, Natasja
AU - Koeneman, Margot M.
AU - Van De Sande, Anna J.M.
AU - Penders, Charlotte G.J.
AU - Piek, Jurgen M.J.
AU - Kooreman, Loes F.S.
AU - Van Kuijk, Sander M.J.
AU - Hoosemans, Linde
AU - Sep, Simone J.S.
AU - De Vos Van Steenwijk, Peggy J.
AU - Van Beekhuizen, Heleen J.
AU - Slangen, Brigitte F.M.
AU - Nijman, Hans W.
AU - Kruitwagen, Roy F.P.M.
AU - Kruse, Arnold Jan
N1 - Funding Information:
This study was partially funded by a research grant from MEDA Pharmaceuticals. This grant was used to cover costs for the study medication and laboratory analyses. MEDA Pharmaceuticals was not involved in study design, data collection, data analysis and interpretation or the content of the current publication.
Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN.
AB - Topical imiquimod could be an alternative, noninvasive, treatment modality for high-grade cervical intraepithelial neoplasia (CIN). However, evidence is limited, and there are no studies that compared treatment effectiveness and side effects of topical imiquimod cream to standard large loop excision of the transformation zone (LLETZ) treatment. A multi-center, nonrandomized controlled trial was performed among women with a histologic diagnosis of CIN 2/3. Women were treated with either vaginal imiquimod (6.25 mg 3 times weekly for 8 to 16 wk) or LLETZ according to their own preference. Successful treatment was defined as the absence of high-grade dysplasia at the first follow-up interval after treatment (at 20 wk for the imiquimod group and at 26 wk for the LLETZ group). Secondary outcome measures were high-risk human papillomavirus (hrHPV) clearance, side effects, and predictive factors for successful imiquimod treatment. Imiquimod treatment was successful in 60% of women who completed imiquimod treatment and 95% of women treated with LLETZ. hrHPV clearance occurred in 69% and 67% in the imiquimod group and LLETZ group, respectively. This study provides further evidence on topical imiquimod cream as a feasible and safe treatment modality for high-grade CIN. Although the effectiveness is considerably lower than LLETZ treatment, imiquimod treatment could prevent initial surgical treatment in over 40% of women and should be offered to a selected population of women who wish to avoid (repeated) surgical treatment of high-grade CIN.
UR - http://www.scopus.com/inward/record.url?scp=85126057001&partnerID=8YFLogxK
U2 - 10.1097/CJI.0000000000000414
DO - 10.1097/CJI.0000000000000414
M3 - Article
C2 - 35180719
AN - SCOPUS:85126057001
SN - 1524-9557
VL - 45
SP - 180
EP - 186
JO - Journal of Immunotherapy
JF - Journal of Immunotherapy
IS - 3
ER -
