Aging and the treatment of basal cell carcinoma
We describe how a patient ’s life expectancy can be estimated and combined with tumor characteristics to determine lag time to benefit, a concept to better understand whether patients will experience the efficacy of a treatment within their life span.
Accurate counting of nonmelanoma skin cancer in fair-skinned populations remains challenging due to high event rates. In the past, epidemiology data have often been limited to collection of the number of people affected, rather than the number of tumours. Venables and coauthors report on pathology data from across the U.K., which identified the first basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) each year in 2013 –2015 across the U.K. European age-standardized incidence rates of the first BCC and cSCC per patient per annum were 285 and 77 per 100 000 person-years, respectively.
Non-melanoma skin cancer (NMSC) is the most common cancer worldwide. Australia has the highest incidence of skin cancer in the world, exceeding 2000 per 100 000 person-years and it is increasing . In the USA, more than 3 million individuals are diagnosed with NMSC each year [2,3]. In the UK, during 2014–2016, about 147 000 new NMSC cases were diagnosed every year, more than 400 every day . Data show that between 1976 and 1984, the overall inc idence of basal cell carcinoma (BCC) increased by 145% and of cutaneous squamous cell carcinoma (cSCC) by 263%.
ConclusionThe results of this exploratory analysis of vismodegib withdrawal are consistent with a substantial link between treatment response and patients ’ HRQoL. Furthermore, 11 out of 35 (31%) patients that reported a complete remission of the disease after 6 months of vismodegib treatment reported BCC recurrence. These data highlight the importance of continuous follow-up and perhaps different regimens of treatment, such as an alternate dose re gimen to maintain disease control and reduce the adverse events as previously described in the literature.
The molecular weight of methotrexate (MTX) makes cutaneous penetration difficult. Oxygen flow could enhance the skin permeation of MTX diluted in the LP3 carrier system. This pilot study aims to assess the efficacy, safety and tolerance of oxygen-flow-administered (OFA)-LP3-MTX3% for treating superficial skin cancers. Patients with superficial basal cell carcinoma (sBCC)(n=12), extramammary Paget ’s disease (EMPD)(n=5), mycosis fungoides classic type (CMF) (n=10) and folliculotropic (FMF) (n=6) were included in the study and were treated with 4 weekly applications of OFA-LP3-MTX3%.
Transplant recipients have a significantly higher risk of developing non-melanoma skin cancers compared with the general population and squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most common post-transplant malignancies. Although in the general population BCC outnumbers SCC 4:1, in transplant patients this ratio is reversed and SCC is more common, with a 65- to 250-fold increased incidence. As patients in immunosuppressed states are living longer after transplants, the incidence of skin cancer in this population continues to increase.
Conclusions: Studying demographics and tumor characteristics aid in understanding the utilization patterns of MMS. PMID: 31474170 [PubMed - as supplied by publisher]
Cyclooxygenase-2 (COX-2) inhibitor has been associated with lower risk of several cancers, but epidemiological studies on skin cancer risk have been limited and inconclusive. COX-2 inhibitor use and risk of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and melanoma were evaluated in three prospective cohorts - the Nurses ’ Health Study (NHS, 2000-2012), NHS II (2001-2011), and the Health Professionals Follow-up Study (HPFS, 2002-2012). COX-2 inhibitor use and skin cancer incidence were assessed using biennial questionnaires, with cSCC and melanoma cases verified by pathological records.
The pathogenesis of basal cell carcinoma (BCC) is multifactorial and not fully elucidated. Previous studies showed, that behaviour of the tumour may be influenced by immune system and identified CD4+CD25+FoxP3+ regulatory T cells (Tregs) as a dominant immune cells in BCC microenvironment. The function and development of Tregs is regulated by FOXP3 encoding transcription factor, Forkhead box P3 (FoxP3). FoxP3 regulates transcription of many genes, including up-regulation of cytotoxic lymphocyte-associated antigen-4 gene (CTLA-4).
Basal cell carcinoma (BCC) environment consists of stromal and inflammatory cells which produce variety of cytokines, chemokines and growth factors that may affect the tumor behavior. One of the cytokines suggested to be involved in the pathogenesis of BCC is IL-6 - the upstream element of IL-6/JAK/STAT3 pathway. In the present study rs1800795 (-174 G/C) IL-6 gene polymorphism and STAT3 rs2293152 (intron 11, C/G) and rs4796793 ( –1697, C/G) polymorphisms were assessed in relation to the BCC risk and clinical course.
Basal cell carcinoma (BCC) is the most common cutaneous neoplasia in fair-skinned individuals usually characterized by locally destructive growth and invasion of surrounding tissue. BCC is primarily driven by the aberrant activation of the Sonic Hedgehog pathway (HH), with the majority of BCCs carrying mutations in PTCH1 or SMO genes. However, the great variability in morphology, aggressiveness and response to treatment of BCC remains unexplained and highlights the hypothesis that additional genes might contribute to tumorigenesis of different BCC subtypes.