+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Imiquimod in cervical, vaginal and vulvar intraepithelial neoplasia: a review



Imiquimod in cervical, vaginal and vulvar intraepithelial neoplasia: a review



Gynecologic Oncology 139(2): 377-384



Human papillomavirus (HPV) infection is in the vast majority of patients accountable for the development of vulvar, cervical and vaginal intraepithelial neoplasia (VIN, CIN, VAIN); precursors of vulvar, cervical and vaginal cancers. The currently preferred treatment modality for high grade VIN, CIN and VAIN is surgical excision. Nevertheless surgical treatment is associated with adverse pregnancy outcomes and recurrence is not uncommon. The aim of this review is to present evidence on the efficacy, safety and tolerability of imiquimod (an immune response modifier) in HPV-related VIN, CIN and VAIN. A search for papers on the use of imiquimod in VIN, CIN and VAIN was performed in the MEDLINE, EMBASE and Cochrane library databases. Data was extracted and reviewed. Twenty-one articles met the inclusion criteria and were analyzed; 16 on VIN, 3 on CIN and 2 on VAIN. Complete response rates in VIN ranged from 5 to 88%. Although minor adverse effects were frequently reported, treatment with imiquimod was well tolerated in most patients. Studies on imiquimod treatment of CIN and VAIN are limited and lack uniformly defined endpoints. The available evidence however, shows encouraging effect. Complete response rates for CIN 2-3 and VAIN 1-3 ranged from 67 to 75% and 57 to 86% respectively. More randomized controlled trials on the use of imiquimod in CIN, VAIN and VIN with extended follow-up are necessary to determine the attributive therapeutic value in these patients.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058048730

Download citation: RISBibTeXText

PMID: 26335596

DOI: 10.1016/j.ygyno.2015.08.018


Related references

Imiquimod for treatment of vulvar and vaginal intraepithelial neoplasia. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics 101(1): 3, 2008

LASER VAPORIZATION IN VULVAR INTRAEPITHELIAL NEOPLASIA (VIN), VAGINAL INTRAEPITHELIAL NEOPLASIA (VAIN) AND CONDYLOMATA ACUMINATA: IGCS-0093 Vulvar and Vaginal Cancer. International Journal of Gynecological Cancer 25(Suppl. 1): 75, 2015

Vulvar and Vaginal Cancer, Vulvar Intraepithelial Neoplasia 3 and Vaginal Intraepithelial Neoplasia 3: Experience of a Referral Institute. Israel Medical Association Journal 18(5): 286-289, 2016

Physicians' Awareness, Attitudes, and Experiences Regarding Imiquimod Treatment of Vaginal and Cervical Intraepithelial Neoplasia. Journal of Lower Genital Tract Disease 20(1): 75-79, 2016

Topical imiquimod treatment for human papillomavirus infection in patients with and without cervical/vaginal intraepithelial neoplasia. Taiwanese Journal of Obstetrics and Gynecology 51(4): 533-538, 2012

Organ-preserving laser surgery of vulvar intraepithelial neoplasia and vaginal intraepithelial neoplasia Chances and limitations. Geburtshilfe und Frauenheilkunde 57(8): 440-446, 1997

Imiquimod for vulvar intraepithelial neoplasia. New England Journal of Medicine 359(1): 94; Author Reply 94-5, 2008

Efficacy of 5% imiquimod for the treatment of Vaginal intraepithelial neoplasia-A systematic review of the literature and a meta-analysis. European Journal of Obstetrics Gynecology and Reproductive Biology 218: 129-136, 2017

Clinical analysis of patients underwent hysterectomy for stage I cervical cancer or high grade cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia. Zhonghua Fu Chan Ke Za Zhi 50(7): 516-521, 2015

Human papillomavirus type 16 in vulvar carcinoma vulvar intraepithelial neoplasia and associated cervical neoplasia. Gynecologic Oncology 42(1): 22-26, 1991

Misdiagnosis of high-grade vulvar intraepithelial neoplasia (VIN III) as mild cervical intraepithelial neoplasia (CIN I) on Papanicolaou tests. Archives of Pathology & Laboratory Medicine 127(1): 68-70, 2003

Misdiagnosis of high-grade vulvar intraepithelial neoplasia as mild cervical intraepithelial neoplasia on Papanicolaou tests. Archives of Pathology & Laboratory Medicine 127(1): 68-70, 2003

Treatment of vulvar intraepithelial neoplasia 2/3 with imiquimod. Journal of Reproductive Medicine 47(5): 395-398, 2002

Synchronous vulvar intraepithelial neoplasia (VIN) of warty type and cervical intraepithelial neoplasia (CIN): case report. Indian Journal of Pathology and Microbiology 49(4): 585-587, 2006

Treatment of Vulvar Intraepithelial Neoplasia with Topical Imiquimod. Yearbook of Dermatology and Dermatologic Surgery 2009: 178-179, 2009