New topical immunotherapy effective against early skin cancer

https://www.eurekalert.org/pub_releases/2016-11/wuso-nti111816.php

Public Release: 21-Nov-2016
New topical immunotherapy effective against early skin cancer
Combination of two drugs reduces precancerous skin lesions
Washington University School of Medicine

A combination of two topical drugs that have been in use for years triggers a robust immune response against precancerous skin lesions, according to a new study. The research, from Washington University School of Medicine in St. Louis and Harvard Medical School, shows that the therapy activates the immune system's T cells, which then attack the abnormal skin cells.

The study, which involved patients with actinic keratosis, a precursor to a type of skin cancer called squamous cell carcinoma, is published Nov. 21 in The Journal of Clinical Investigation.

"We looked at precancerous lesions on patients with sun-damaged skin," said Washington University dermatologist and study co-author Lynn A. Cornelius, MD, director of the Division of Dermatology. "Most commonly found on the face, scalp and arms, these lesions appear abnormal by visual examination and under the microscope but are not full-blown skin cancers. But because these lesions have the potential to develop into a true skin cancer, they are commonly treated. Our study shows this combination therapy is more effective and better tolerated than current treatment practices."

On average, the investigational therapy reduced the number of precancerous skin lesions on the face by almost 88 percent compared with a 26 percent reduction using the standard chemotherapy. While some side effects such as skin scaling and itching were similar with both treatments, patients receiving the investigational therapy reported more redness and increased burning sensations, which are consistent with the immune response it triggers. Interestingly, although not specifically measured, patients who had been treated previously with conventional therapies reported decreased pain and discomfort with the combination treatment, according to Cornelius, who is also the Winfred A. and Emma R. Showman Professor of Dermatology.

The investigational treatment combines a cream formulation of a chemotherapy drug called 5-fluorouracil with a synthetic form of vitamin D called calcipotriol. Topical 5-fluorouracil alone is prescribed to treat actinic keratosis. Calcipotriol is approved by the Food and Drug Administration (FDA) for treatment of psoriasis, an autoimmune disorder characterized by red, scaly patches of skin.

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