FAILURE OF ISOTRETINOIN AND INTERFERON-ALPHA COMBINATION THERAPY FOR HPV-LINKED SEVERE VULVAR DYSPLASIA - A REPORT OF 2 CASES

BACKGROUND: Retinoids (RA) and interferon (IFN) have been reported to be active against a variety of tumors and human papillomavirus (HPV)-r elated lesions. Because chronic and recurrent HPV-linked vulvar intrae pithelial neoplasia 3 (VIN 3) have a high risk of invasion, we evaluat ed combined therapy of IFN-alpha with 13-cis-retinoic acid (13 cRA) in the treatment gf two VIN 3 cases of this type. CASE: Two patients wit h chronic and recurrent VIN 3 were treated with combined therapy of IF N-alpha (4.5x10(6) five times a week) and 13 cRA (1 mg/kg/d) for six m onths. Clinical regression was observed at the end of treatment in bot h cases, but histologic features of VIN 3 were still present. CONCLUSI ON: These data demonstrate the ineffectiveness of the combined regimen of IFN-alpha and 13 cRA with this schedule for a period of six months in recurrent and chronic VIN 3.