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International Ophthalmology

, Volume 39, Issue 2, pp 295–301 | Cite as

Role of topical interferon alpha-2b in ‘mitomycin-C-resistant’ ocular surface squamous neoplasia: our preliminary findings

  • Manpreet SinghEmail author
  • Natasha Gautam
  • Manpreet Kaur
Original Paper

Abstract

Purpose

To report the clinical presentation of mitomycin-C (MMC)-resistant ocular surface squamous neoplasia (OSSN) and its treatment outcome with topical interferon alpha-2b (IFNα-2b).

Methods

A prospective, non-randomised, pilot study enrolling clinically diagnosed OSSN patients. The inclusion criterion was resistance of OSSN to standard topical MMC (0.02%) chemotherapy. The resistance was defined as ‘no clinical response’ in the terms of reduction in tumour size, extension and vascularity after minimum 6 weeks ‘on-cycles’ of MMC. Any previous surgical intervention or recurrent OSSN lesions were excluded. Topical MMC was stopped in all, and topical IFNα-2b (1million IU/ml) eyedrops were prescribed to each patient. At first presentation, the clinical features and side-effect profile of MMC was noted and therapeutic effect of IFNα-2b was clinically monitored at each follow-up. Topical immunotherapy was continued for 24 weeks and a minimum follow-up of 12 weeks was observed after stopping IFNα-2b.

Results

Six patients with a mean age of 62 years met the inclusion criteria. At presentation, all had unilateral, circumscribed, sessile and unifocal lesions with mean dimensions of 7.67 × 5.17 mm. Four patients had temporal lesions while surface keratin, pigmentation and corneal involvement were noted in three lesions, separately. All lesions had dilated and tortuous feeder vessels. All six tumours resolved completely over a mean tumour resolution time of 16 weeks while the total duration of IFNα-2b treatment was 24 weeks. After stopping immunotherapy, a mean of 14.5 weeks follow-up was observed. None showed any recurrence. The approximate cost of total therapy session was 8400 Indian rupees.

Conclusion

The OSSN lesions showing ‘less or no response’ to topical MMC may be shifted to topical recombinant IFNα-2b before proceeding for a surgical excision.

Keywords

Ocular surface squamous neoplasia Interferon alpha-2b Topical mitomycin-C Chemotherapy resistance 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The written informed consent was obtained from all the participants before starting topical interferon therapy.

References

  1. 1.
    Nanji AA, Moon CS, Galor A, Sein J, Oellers P, Karp CL (2014) Surgical versus medical treatment of ocular surface squamous neoplasia: a comparison of recurrences and complications. Ophthalmology 121:994–1000CrossRefGoogle Scholar
  2. 2.
    Sturges A, Butt AL, Lai JE, Chodosh J (2008) Topical interferon or surgical excision for the management of primary ocular surface squamous neoplasia. Ophthalmology 115:1297–1302CrossRefGoogle Scholar
  3. 3.
    Poothullil AM, Colby KA (2006) Topical medical therapies for ocular surface tumors. Semin Ophthalmol 21:161–169CrossRefGoogle Scholar
  4. 4.
    Wilson MW, Hungerford JL, George SM, Madreperla SA (1997) Topical mitomycin C for the treatment of conjunctival and corneal epithelial dysplasia and neoplasia. Am J Ophthalmol 124:303–311CrossRefGoogle Scholar
  5. 5.
    Yeatts RP, Ford JG, Stanton CA, Reed JW (1995) Topical 5-fluorouracil in treating epithelial neoplasia of the conjunctiva and cornea. Ophthalmology 102:1338–1344CrossRefGoogle Scholar
  6. 6.
    Shah SU, Kaliki S, Kim HJ, Lally SE, Shields JA, Shields CL (2012) Topical interferon alfa-2b for management of ocular surface squamous neoplasia in 23 cases: outcomes based on American Joint Committee on Cancer classification. Arch Ophthalmol 130:159–164CrossRefGoogle Scholar
  7. 7.
    Luqmani YA (2005) Mechanisms of drug resistance in cancer chemotherapy. Med Princ Pract 14:35–48CrossRefGoogle Scholar
  8. 8.
    Housman G, Byler S, Heerboth S, Lapinska K, Longacre M, Snyder N, Sarkar S (2014) Drug resistance in cancer: an overview. Cancers 6:1769–1792CrossRefGoogle Scholar
  9. 9.
    Gorlick R, Goker E, Trippett T, Waltham M, Banerjee D, Bertino JR (1996) Intrinsic and acquired resistance to methotrexate in acute leukemia. N Engl J Med 335:1041–1048CrossRefGoogle Scholar
  10. 10.
    Ashkenazy N, Karp CL, Wang G, Acosta CM, Galor A (2017) Immunosuppression as a possible risk factor for interferon nonresponse in ocular surface squamous neoplasia. Cornea 36:506–510CrossRefGoogle Scholar
  11. 11.
    Tabin G, Levin S, Snibson G, Loughnan M, Taylor H (1997) Late recurrences and the necessity for long-term follow-up in corneal and conjunctival intraepithelial neoplasia. Ophthalmology 104:485–492CrossRefGoogle Scholar
  12. 12.
    Stone DU, Butt AL, Chodosh J (2005) Ocular surface squamous neoplasia: a standard of care survey. Cornea 24:297–300CrossRefGoogle Scholar
  13. 13.
    Shields CL, Kaliki S, Kim HJ, Al-Dahmash S, Shah SU, Lally SE, Shields JA (2013) Interferon for ocular surface squamous neoplasia in 81 cases: outcomes based on the American Joint Committee on Cancer classification. Cornea 32:248–256CrossRefGoogle Scholar
  14. 14.
    Shields CL, Demirci H, Karatza E, Shields JA (2004) Clinical survey of 1643 melanocytic and nonmelanocytic conjunctival tumors. Ophthalmology 111:1747–1754CrossRefGoogle Scholar
  15. 15.
    Kao AA, Galor A, Karp CL, Abdelaziz A, Feuer WJ, Dubovy SR (2012) Clinicopathologic correlation of ocular surface squamous neoplasms at Bascom Palmer Eye Institute: 2001–2010. Ophthalmology 119:1773–1776CrossRefGoogle Scholar
  16. 16.
    Kieval JZ, Karp CL, AbouShousha M, Galor A, Hoffman RA, Dubovy SR, Wang J (2012) Ultra-high resolution optical coherence tomography for differentiation of ocular surface squamous neoplasia and pterygia. Ophthalmology 119:481–486CrossRefGoogle Scholar
  17. 17.
    Xu Y, Zhou Z, Xu Y, Wang M, Liu F, Qu H, Hong J (2012) The clinical value of in vivo confocal microscopy for diagnosis of ocular surface squamous neoplasia. Eye 26:781–787CrossRefGoogle Scholar
  18. 18.
    Maskin SL (1994) Regression of limbal epithelial dysplasia with topical interferon (letter). Arch Ophthalmol 112:1145–1146CrossRefGoogle Scholar
  19. 19.
    Boehm MD, Huang AJ (2004) Treatment of recurrent corneal and conjunctival intraepithelial neoplasia with topical interferon alfa 2b. Ophthalmology 111:1755–1761CrossRefGoogle Scholar
  20. 20.
    Singh M, Gautam N, Gupta A, Kaur M (2016) Interferon alfa-2b in the management of recurrent conjunctival papillomatosis. Indian J Ophthalmol 64:778–780CrossRefGoogle Scholar
  21. 21.
    Peksayar G, Altan-Yaycioglu R, Onal S (2003) Excision and cryosurgery in the treatment of conjunctival malignant epithelial tumours. Eye (Lond) 17:228–232CrossRefGoogle Scholar
  22. 22.
    Siganos CS, Kozobolis VP, Christodoulakis EV (2002) The intraoperative use of mitomycin-C in excision of ocular surface neoplasia with or without limbal autograft transplantation. Cornea 21:12–16CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia

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