Topical immunotherapy with diphencyprone (DPCP) for in-transit and unresectable cutaneous melanoma lesions: an inaugural Canadian series

Expert Rev Clin Immunol. 2017 Apr;13(4):383-388. doi: 10.1080/1744666X.2017.1286984. Epub 2017 Feb 6.

Abstract

Background: Diphencycprone (DPCP) is an immune contact sensitizer applied to melanoma lesions. Early studies show favorable efficacy. We present the first North-American series of patients treated with DPCP.

Methods: A single center retrospective study of patients with in-transit or unresectable melanoma lesions treated with DPCP from December 1,2014 to December 31,2015 was completed. Primary objectives were response rate and toxicity. Secondary objective was health-related quality of life assessment with the Functional Assessment of Cancer Therapy-Melanoma (FACT-M) questionnaire.

Results: Fifteen consecutive patients were identified with median age of 78 (range 43-92). 73% of patients had prior treatment. Two patients (13%) had a complete response after 25 and 32 weeks, respectively. Four patients (27%) had a partial response with a mean treatment time of 30 weeks (range 6-51 weeks). Six (40%) had stable disease. Six patients stopped DPCP - three from systemic progression and three from toxicity. The most common toxicity was blisters; one patient had significant skin ulceration that resolved on stopping DPCP. Median FACT-M score was 142.95 (possible total 172). Mean overall follow-up time was 22.7 weeks.

Conclusion: DPCP is a feasible option for in-transit and other melanoma cutaneous lesions ineligible/refractory to surgery and may delay need for systemic therapy.

Keywords: Diphencyprone; immunotherapy; in-transit metastasis; melanoma; toxicity.

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Canada
  • Cyclopropanes / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunization
  • Immunotherapy / methods*
  • Male
  • Melanoma / immunology
  • Melanoma / therapy*
  • Middle Aged
  • Quality of Life
  • Retrospective Studies
  • Skin / drug effects*
  • Skin / pathology
  • Skin Neoplasms / immunology
  • Skin Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Cyclopropanes
  • diphenylcyclopropenone