Intralesional BCG application in malignant melanoma

Area of Science:

• Oncology
• Immunology
• Dermatology

Background:

• Malignant melanoma immunotherapy utilizes Bacillus Calmette-Guerin (BCG).
• BCG treatment strategies include minimum residual disease management and direct intralesional application.
• Relapsing malignant melanoma patients were the focus of this study.

Purpose of the Study:

• To evaluate the efficacy of direct intralesional BCG application in patients with relapsing malignant melanoma.
• To assess local reactions, systemic side effects, and the response of non-injected lesions.
• To determine the impact of BCG immunotherapy on local tumor regression and remission.

Main Methods:

• Direct intralesional BCG application was administered to 19 patients with histologically confirmed malignant melanoma.
• Patients were divided into two groups: Group A (relapse confined to the primary region, n=10) and Group B (distant dissemination present, n=9).
• Clinical and cytological evaluations focused on local and systemic reactions, and the response of non-injected lesions.

Main Results:

• Local regression was achieved in 8/10 patients in Group A and 6/9 patients in Group B.
• Complete remission lasting 4-6 months was observed in 4/10 patients in Group A.
• Regression of non-injected lesions occurred in 4/10 patients in Group A and 1/9 patients in Group B.
• Systemic reactions included febrile responses, nausea, vomiting, and joint pain, typically resolving within 24 hours.
• Pretreatment with antipyretic and antihistaminic drugs mitigated systemic side effects.

Conclusions:

• Direct intralesional BCG immunotherapy demonstrates efficacy in achieving local regression of malignant melanoma, particularly in patients without distant dissemination.
• Complete remission is achievable in a subset of patients, highlighting BCG's potential in melanoma treatment.
• Systemic side effects are common but manageable with supportive care, and pretreatment can alleviate discomfort.