Use of interferon alpha 2b to manage conjunctival primary acquired melanosis and conjunctival melanoma |
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| Institution: | 1. Department of Ophthalmology, University Hospital Arnau de Vilanova, Lleida, Spain;2. School of Medicine, University of Lleida, Lleida, Spain;3. Biomedical Research Institute of Lleida, University of Lleida, Lleida, Spain;1. South Australian Institute of Ophthalmology, The University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia;2. Tun Hussein Onn National Eye Hospital, Selangor, Malaysia;1. Southampton Eye Unit, University Hospital Southampton Foundation Trust, Southampton, United Kingdom;2. Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Messina, Italy;3. Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Norte, EPE - Hospital de Santa Maria, Lisbon, Portugal;4. Department of Ophthalmology, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal;5. Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, USA |
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| Abstract: | Primary acquired melanosis (PAM) is acquired conjunctival pigmentation that can give rise to conjunctival melanoma (CM), a malignant tumor of the bulbar and palpebral conjunctiva or the caruncle. Surgical excision is the treatment of choice for this neoplasm. Topical chemotherapy is also used for patients with PAM with atypia or CM and, in patients with recurrent or extensive disease, this may be an important option. Of the several chemotherapeutic drugs used, topical interferon alpha 2b (IFN-α2b) has become popular because of its low toxicity. Clinical evidence from case reports and case series supports the efficacy of IFN-α2b as the preferred adjuvant treatment for PAM and CM. In addition, topical IFN-α2b has been successfully applied to melanocytic tumors refractory to other treatments, such as cryotherapy and topical mitomycin C. In patients with locally advanced CM, the combination of IFN-α2b and systemic immunotherapy may serve as an alternative to exenteration. Given the low frequency of CM, long-term multicenter studies are needed to demonstrate the efficacy of IFN-α2b for preventing local recurrence and distant metastasis. |
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