By Amy Norton
HealthDay reporter
MONDAY, Aug 9, 2021 (HealthDay News) – An experimental gel showed early promise in treating the most common form of skin cancer – suggesting a possible alternative to surgery in the future.
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 usually well curable by surgical removal.
Even so, non-surgical options are required, said lead researcher Dr. Kavita Sarin, an associate professor of dermatology at Stanford University in Redwood City, California.
For example, in some cases, the skin cancer may be in an area – like the face – where surgery could leave scars that patients want to avoid. Also, according to Sarin, many people develop multiple basal cell carcinomas over time, which means they will return to repeated surgeries.
A few topical drugs are approved for BCC, but only for “superficial” cancers, which make up a minority of cases, Sarin said.
For the new study, her team tested an experimental topical drug called remetinostat, which blocks an enzyme called histone deacetylase. Laboratory research has shown that inhibiting the enzyme can suppress BCC growth.
The study – published Aug. 6 in Clinical Cancer Research – was a small, mid-stage study that aimed to determine if the topical drug was working at all.
And most of the patients, Sinar’s team found, did: of 33 skin cancers treated for six weeks, 17 healed completely and six others partially responded – meaning their diameter has shrunk by at least 30% .
The gel appeared to be most effective against superficial BCC, with all of these skin tumors shrinking or disappearing, the researchers found. But around two thirds of the other types of tumors also reacted – including nodular BCC, the most common form of cancer, and “infiltrative” tumors that can penetrate deeper and further into the skin.
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 study included three daily applications of the gel for six weeks.
“This was a small pilot study just to see if there was any effectiveness,” she noted.
Then the question arises how long the effect lasts. “The durability of the treatment will be the main issue in the future,” said Sarin.
The first results are promising, says Dr. Jeffrey Weinberg, Associate Clinical Professor of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City.
“Of course we need more data,” said Weinberg, who was not involved in the research. “But that is certainly a step forward.”
He added that the effects on the infiltrative tumors – with two out of three fully responding – were “impressive”.
One disadvantage of a topical gel over surgery, says Weinberg, is that there is no way of knowing whether the tumor has actually been completely eradicated.
In this study, the researchers performed surgical excisions after the treatment period ended and found that 17 tumors had completely healed. But in the “real world” where topical treatment would be used as a surgical alternative, this won’t happen, Weinberg pointed out.
Still, he said, some people with BCC are not candidates for surgery while others would prefer to avoid it, so an additional, effective topical option would be welcome.
Sarin said, “I am optimistic that in the future we can treat this as more of a nuisance than a cancer that requires surgery.”
The study was funded in part by Medivir, the Swedish biotech company that develops Remetinostat.
More information
The Skin Cancer Foundation has more about basal cell carcinoma treatment.
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; Clinical Cancer Research, August 6, 2021, online
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