Imiquimod vs Surgery RCT in Vulvar VIN

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Gerda Trutnovsky to discuss the use of imiquimod versus surgery for the treatment of vHSIL. Dr. Trutnovsky studied at the University of Graz/Austria and the University of Sydney/Australia. She works as an associate professor in the Department of Obstetrics and Gynecology at the Medical University of Graz/Austria, with a special interest in vulvar disease. Highlights: This was the first prospective trial of imiquimod versus surgery for the treatment of vulvar high grade squamous intraepithelial lesions (vHSIL). Complete clinical response at 6 months was observed in 80% of patients using imiquimod per-protocol, compared to 79% in women who had one surgical intervention. Imiquimod was used in a slowly escalating dosage scheme up to 3 times a week and reduced in case of side effects – local toxicity was mostly mild to moderate.

Imiquimod is a safe, effective and well accepted alternative to surgery and can be considered a first-line treatment option.