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A. Okazaki, T. Fukuda, Y. Yamazaki, T. Shiohara, Pretreatment with topical glucocorticosteroids to enhance the antitumour efficacy of imiquimod: long‐term follow‐up in Bowen disease, British Journal of Dermatology, Volume 176, Issue 4, 1 April 2017, Pages 1079–1082, https://doi.org/10.1111/bjd.14996
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Conflicts of interest: none declared.
Dear Editor, Despite the initial enthusiasm, the efficacy of imiquimod (IMQ) has been limited to a given disease setting.1 Therefore, we need adjunct therapies to improve the antitumour efficacy of IMQ.
We initially hypothesized that decreasing the recruitment of Foxp3+ regulatory T cells (Tregs) to the tumour site before IMQ therapy could have therapeutic value. Furthermore, our preliminary study demonstrated that topical IMQ therapy for Bowen disease (BD) led to a decreased frequency of Tregs in the dermal infiltrates at the tumour burden site, thereby facilitating tumour regression. Hence, we searched for a desirable method of efficiently enhancing the elimination of Tregs from the surrounding area. We found that topical glucocorticosteroids profoundly depleted tumour‐associated Tregs and that IMQ efficacy greatly improved when initiated shortly after topical glucocorticosteroids. Here, we investigated whether sequential therapy using topical glucocorticosteroids and IMQ could produce a higher clearance rate in BD than IMQ monotherapy.
