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Interferon for Ocular Surface Squamous Neoplasia in 81 Cases: Outcomes Based on the American Joint Committee on Cancer Classification

Shields, Carol L. MD; Kaliki, Swathi MD; Kim, H. Jane MD; Al-Dahmash, Saad MD; Shah, Sanket U. MD; Lally, Sara E. MD; Shields, Jerry A. MD

doi: 10.1097/ICO.0b013e3182523f61
Clinical Science

Purpose: To assess the efficacy of interferon alpha-2b (IFNα2b) in the management of ocular surface squamous neoplasia (OSSN).

Methods: This is a retrospective, nonrandomized interventional case series study of 80 patients with 81 tumors treated with IFNα2b eye drops and/or injection combined with surgical excision when necessary. The main outcome measure was complete response or partial response based on the American Joint Committee on Cancer classification.

Results: The OSSN was classified as Tis (n = 10, 12%), T1 (n = 13, 16%), T2 (n = 6, 7%), T3 (n = 51, 63%), and T4 (n = 1, 1%). IFNα2b was used as immunotherapy alone (n = 22, 27%) or combined with surgery (n = 59, 73%). Overall (n = 81), complete response was achieved in 90% Tis, in 100% T1, in 100% T2, in 94% T3, and in 100% T4. Specifically for immunotherapy (n = 22), IFNα2b alone achieved complete response in 75% (3/4) Tis, in 100% (8/8) T1, and in 70% (7/10) T3. Planned IFNα2b plus surgery (n = 59) achieved control in 100% (6/6) Tis, in 100% (5/5) T1, in 100% (6/6) T2, in 100% (41/41) T3, and in 100% (1/1) T4. Tumor recurrence was noted in 5% (4/81) of cases over a median follow-up of 1 year. Ocular side effects included conjunctival hyperemia (n = 4, 5%), ocular irritation (n = 3, 4%), superficial punctate keratitis (n = 3, 4%), and conjunctival follicles (n = 1, 1%). Systemic side effects included postinjection flu-like syndrome for 1 day (n = 7, 9%).

Conclusions: IFNα2b, when appropriately combined with surgical excision for OSSN, provides complete control in 95% of cases overall, specifically in 90% Tis, in 100% T1, in 100% T2, in 94% T3, and in 100% T4.

*Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA

Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Reprints: Carol L. Shields, Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Suite 1440, 840 Walnut St, Philadelphia, PA 19107 (e-mail: carol.shields@shieldsoncology.com).

Supported by Eye Tumor Research Foundation, Philadelphia (C.L.S.); Mellon Charitable Giving from the Martha W. Rogers Charitable Trust (C.L.S.); and American Society of Cataract and Refractive Surgery Foundation (H.J.K.).

The authors state that they have no conflicts of interest to disclose.

Received January 19, 2012

Accepted February 24, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.