MONDAY, Aug.9, 2021 (HealthDay News) – An experimental gel has shown promise in treating the most common form of skin cancer, suggesting a possible alternative to surgery in the future.
The researchers tested the gel on 30 patients with basal cell carcinoma (BCC), a skin cancer diagnosed in more than 3 million Americans each year. The tumors rarely spread and are highly curable, usually by surgical removal.
Still, nonsurgical options are needed, said lead researcher Dr. Kavita Sarin, an associate professor of dermatology at Stanford University, in Redwood City, California.
In some cases, for example, skin cancer may be located in an area, such as the face, where surgery could leave scars that patients want to avoid. Also, Sarin said, many people develop multiple basal cell carcinomas over time, which means coming back for repeated surgeries.
A couple of topical drugs are approved for the BCC, but only for “superficial” cancers, which account for a minority of cases, Sarin said.
For the new study, his team tested an experimental topical drug called remetinostat, which blocks an enzyme known as histone deacetylase. Laboratory research has shown that inhibition of the enzyme can inhibit the growth of BCC.
The study, published Aug. 6 in Cancer clinical research– It was a small, mid-stage trial, designed to see if topical medication worked at all.
And for most patients, Sarin’s team found, yes: of 33 skin cancers treated for six weeks, 17 resolved completely and six more responded partially, meaning they were reduced by at least 30% of the time. diameter.
The gel seemed more effective against superficial BCC, and all of those skin tumors would shrink or disappear, the researchers found. But about two-thirds of the other tumor types also responded, including nodular BCC, the most common form of cancer, and “infiltrative” tumors, which can invade the skin more deeply and broadly.
The main side effect was a rash at the application site.
Sarin said more studies are needed to “optimize” the treatment regimen, which in this trial consisted of three daily applications of the gel, for six weeks.
“This was a small pilot study just to see if there is efficacy,” he noted.
Then there is the question of how long the effects last. “The durability of the treatment will be the main issue in the future,” said Sarin.
Initial results are promising, according to Dr. Jeffrey Weinberg, associate clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City.
“Obviously we need more data,” said Weinberg, who was not involved in the research. “But this is certainly progress.”
He added that the effects on infiltrating tumors, with two out of three fully responding, were “impressive.”
One downside to a topical gel versus surgery, Weinberg noted, is that there is no way to know if the tumor has actually been completely removed.
In this trial, the researchers performed surgical excisions after the end of the treatment period and verified that 17 tumors had completely resolved. But in the “real world,” where topical treatment would be used as a surgical alternative, that won’t happen, Weinberg said.
Still, he said, some people with BCC are not candidates for surgery, while others would prefer to avoid it, so an additional and effective topical option would be welcome.
Sarin said: “I am optimistic that in the future we will be able to treat this more as a nuisance than a cancer that needs to be treated surgically.”
The study was funded in part by Medivir, the Swedish biotech company that develops remetinostat.
The Skin Cancer Foundation has more about treating basal cell carcinoma.
SOURCES: Kavita Sarin, MD, PhD, associate professor, dermatology, Stanford University School of Medicine, Redwood City, California; Jeffrey Weinberg, MD, associate clinical professor, dermatology, Icahn School of Medicine at Mount Sinai, New York City; Cancer clinical research, August 6, 2021, online