Real‐world experience of off‐label use of imiquimod 5% as an adjuvant therapy after surgery or as a monotherapy for lentigo maligna

Characteristics and management of skin cancers in very elderly patients: A real‐world challenge for clinicians

“…As for NMSC, international guidelines recommend surgery as primary treatment for in situ melanoma but, when not feasible due to comorbidities or cosmetically sensitive tumour location, topical imiquimod has demonstrated high rates of clearance both clinical and histologic (70%-100%) and low recurrence rate (0%-4%). [48][49][50] In line with previous studies, our results confirm that most older patients with keratinocyte cancer die within 5 years after diagnosis for unrelated causes, suggesting that some elderly patients may not live long enough to benefit from treatment of low-risk skin tumours but may be at risk of potential short-term treatment complications. 51,52 Literature data have highlighted the debate on whether it's appropriate to treat or not to treat elderly patients.…”

“…Of the 3 patients diagnosed with in situ melanoma, 2 were treated with imiquimod 5% cream while 1 with surgery. As for NMSC, international guidelines recommend surgery as primary treatment for in situ melanoma but, when not feasible due to comorbidities or cosmetically sensitive tumour location, topical imiquimod has demonstrated high rates of clearance both clinical and histologic (70%–100%) and low recurrence rate (0%–4%) 48–50 …”

European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2022

“…However, several retrospective analyses and phase II trials support a role for topical imiquimod as a potential alternative to surgery in selected cases not eligible for surgery or radiotherapy [23], as well as for incompletely excised tumors or as an adjuvant option for those treated through narrow margins [24]. Recently, a 95% cure rate after a mean follow-up of three years has been reported with adjuvant imiquimod following conventional surgery with narrow margins [25]. The complete response rate to imiquimod treatment is in the range of 75%e88% [26e28].…”

Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up

“…There is no approved or recommended treatment regimen. There are several reports of imiquimod's therapeutic usefulness for lentigo maligna before instead of after surgery [ 5 – 7 ]. Usually the 5% cream is applied once daily 5–7 days per week for 12 weeks with a 1–2-cm margin of clinically normal-looking skin [ 1 ].…”