Efficacy and Safety of Laser‐Assisted Combination Chemotherapy: An Explorative Imaging‐Guided Treatment With 5‐Fluorouracil and Cisplatin for Basal Cell Carcinoma

• DOI: 10.1002/lsm.23323
• Publication Date: 2020-09-23T00:50:33Z
• Authors: Emily Wenande; Kristoffer Hendel; Mette Mogensen; Charlotte Bagger; Nina L. Mårtensson; Daniel P. Persson; Catharina M. Lerche; Søren Husted; Christian Janfelt; Katrine Togsverd‐Bo; Richard R. Anderson; Merete Haedersdal
• Keywords: 03 medical and health sciences; Skin Neoplasms; 0302 clinical medicine; Carcinoma, Basal Cell; Lasers, Gas; Humans; Tissue Distribution; Fluorouracil; Cisplatin; Proof of Concept Study; 3. Good health

Background and Objectives Rising incidences of basal cell carcinoma (BCC) have increased the need for effective topical therapies. By enhancing cutaneous uptake chemotherapeutic agents, cisplatin 5‐fluorouracil (5‐FU), laser‐assisted delivery may provide a new combination treatment BCC. Accordingly, this study aimed to evaluate tumor response, safety, drug biodistribution in tumors blood after 5‐FU + CIS BCC patients. Study Design/Materials Methods This open‐label, proof‐of‐concept trial investigated 20 patients with histologically verified, low‐risk superficial or nodular BCCs on face (<20 mm) trunk/extremities (<50 mm). After demarcation guided by optical coherence tomography (OCT), were exposed ablative fractional CO 2 laser followed 60 minutes solution 7‐day exposure 5% cream under occlusion. 30 days, was repeated if any residual identified. Tumor response at day month 3 assessed clinically as well OCT, reflectance confocal microscopy, ultrasound, supplemented histological verification months. Local skin reactions (LSRs) side effects evaluated days 1, 3–5, 14, 30, 3. Drug detection performed subset 1‐ 24 hours treatment. Results Nineteen completed trial, 32% (6/19) receiving single 68% (13/19) treated twice. At months, clinical clearance seen 18/19 corresponding 94% (17/18) achieving clearance. Baseline thickness subtype did not influence number rate ( P ≥ 0.61). LSRs well‐tolerated consisted erythema, edema, erosion, crusting 14. Erythema declined gradually 3, 79% physicians rating cosmesis “good” “excellent.” Scarring hyperpigmentation noted 50% 56%, respectively, while pain infection observed during follow‐up period. Although chemotherapy visualized extending deep layers, no systemic detected patient blood. Conclusion Laser‐assisted shows potential an tolerable option BCC, particularly instances where self‐application is possible in‐office, non‐surgical therapy preferred. Lasers Surg. Med. © 2020 Wiley Periodicals LLC