Treatment of vulvar intraepithelial neoplasia (VIN) with local bleomycin

Surgical management of vulvar intraepithelial neoplasia has resulted in frequent failure or poor patient acceptance. Bleomycin (NSC 125066-Blenoxane, Bristol Laboratories), with its activity against squamous neoplasms, provides an ideal drug for use in the medical management of this disease. Twelve patients were treated with topical and/or intradermal bleomycin. None of those treated topically and only 2 of 10 treated intradermally showed an improvement with this therapy. At the same time 5 of 12 patients progressed to invasive disease. This poor response rate suggests that this form of therapy should not be used with this disease.