Non-melanoma skin cancer

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Research in non-melanoma skin cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat non-melanoma skin cancer. They are also looking for ways to improve the quality of life of people with non-melanoma skin cancer.

The following is a selection of research showing promise for treating non-melanoma skin cancer.

We’ve included information from the following sources. Each item has an identity number that links to a brief overview (abstract).

  • PubMed, US National Library of Medicine (PMID)
  • American Society of Clinical Oncology (ASCO)
  • Canadian Cancer Trials and ClinicalTrials.gov (NCT)

Laser therapy

Laser treatment uses a laser (an intense beam of light) to remove tissue. Researchers are looking for ways to improve laser therapy as a treatment for non-melanoma skin cancer.

Nd:YAG lasers are being looked at as a treatment alternative to surgery, especially in people who are not able to have surgery. A recent study looked at using Nd:YAG lasers on basal cell carcinoma found on the trunk, arms and legs. Results showed that most people required only 1 treatment to remove the cancer completely (Lasers in Surgery and Medicine, PMID 29436720).

CO2 lasers were compared to surgery or cryotherapy as a treatment for basal cell carcinoma on the trunk, arms and legs. Results of the study found that people who had laser surgery had faster healing time and more satisfaction with the treatment. But the cancer came back (recurred) more often after laser therapy when compared to surgery, and people were happier with the results of the surgery (Dermatologic Surgery, PMID 28291062).

Photodynamic therapy (PDT)

Photodynamic therapy (PDT) is a treatment that uses drugs called photosensitizers that can destroy cancer cells when they are exposed to light. Researchers are looking for ways to improve PDT as a treatment for non-melanoma skin cancer.

Laser-mediated photodynamic therapy (PDT) is a newer procedure that uses a laser light source to activate a photosensitizer. Researchers are looking at whether laser-mediated PDT may be a suitable and effective treatment option for non-melanoma skin cancers compared to conventional treatments (Journal of the European Academy of Dermatology and Venereology, PMID 29633367).

Radiation therapy

Radiation therapy uses high-energy rays or particles to destroy cancer cells. Researchers are looking for the best ways to treat non-melanoma skin cancer using different types of radiation therapy.

Electronic brachytherapy is a new type of brachytherapy that places a high-dose-rate x-ray source in a skin applicator close to the skin surface. Different types of applicators, such as molds, flat mats and needles, deliver the radiation to the surface of the skin. Researchers are studying electronic brachytherapy as a treatment for non-melanoma skin cancer (Journal of Dermatological Treatment, PMID 28604229), especially in older people who aren’t well enough for other treatments (Journal of Geriatric Oncology, PMID 30314955; NCT02131805). It is also being compared to Mohs micrographic surgery to see if it is as effective in treating non-melanoma skin cancers that haven’t spread (Journal of Contemporary Brachytherapy, PMID 28951753).

Proton therapy uses protons (a positively charged particle) to treat cancer instead of x-ray beams. Protons release more energy after reaching a certain distance, while x-ray beams release energy before and after they hit their target. So protons cause less damage to tissues they pass through before reaching their target. Proton therapy causes the least amount of damage to nearby normal tissues. It is being studied in clinical trials to treat non-melanoma skin cancer (NCT02923570). Proton therapy is not yet available in Canada.

Find out more about research in radiation therapy.

Targeted therapy and immunotherapy

The following is noteworthy research into targeted therapy and immunotherapy for non-melanoma skin cancer.

Hedgehog pathway inhibitors

A signalling pathway in cells called the hedgehog pathway helps cells develop and grow. It is usually turned off (inactive) in adults. But sometimes changes (mutations) in certain proteins make the pathway and proteins too active. The proteins then send signals that cause cancer to develop, grow and spread quickly. Hedgehog pathway inhibitors are drugs that target these proteins and block the signals.

 

Sonidegib (Odomzo) may be a treatment option for locally advanced or metastatic basal cell carcinoma when it can’t be treated with surgery or radiation therapy (OncoTargets and Therapy, PMID 28352196; Future Oncology, PMID 29119833; Journal of the European Academy of Dermatology and Venereology, PMID 28846163).

Patidegib is given as a gel onto the skin (topical). It is hoped that there will be fewer side effects by giving the drug this way. The drug is being studied as a way to prevent and shrink basal cell carcinoma tumours on the face in people with basal cell nevus syndrome (ASCO, Abstract 16344).

Immune checkpoint inhibitors

Cancer cells sometimes use specific proteins called checkpoints to avoid being attacked by the immune system. This lets the cancer continue to grow because the cancer cells hide from the immune system. Immune checkpoint inhibitors are monoclonal antibodies that work by blocking checkpoint proteins so that immune system cells can attack and kill the cancer cells. Researchers are studying the following immune checkpoint inhibitors in treating non-melanoma skin cancer.

Pembrolizumab (Keytruda) is being examined as a treatment option for advanced or metastatic non-melanoma skin cancer that can’t be removed with surgery. One trial found that pembrolizumab was an effective treatment in elderly people with squamous cell carcinoma (ASCO, Abstract 163428). Clinical trials continue to look at pembrolizumab as a treatment option (NCT03284424, NCT02964559).

Talimogene laherparepvec (T-VEC, Imlygic) is a type of therapy that uses viruses to treat cancer (oncolytic viral therapy). Oncolytic viruses can infect and destroy cancer cells without harming normal cells. T-VEC is injected directly into non-melanoma tumours. It uses a genetically modified herpes simplex virus (HSV) that stimulates cancer cells to make granulocyte-macrophage colony-stimulating factor (GM-CSF). This helps the body recognize and work against the non-melanoma cells. A clinical trial is combining talimogene laherparepvec with nivolumab (Opdivo), which is an immune checkpoint inhibitor, to see if the combination is effective in people with non-melanoma skin cancer that is no longer responding to other treatments (NCT02978625).

Histone deacetylases

Histone deacetylases (HDACs) are a family of enzymes involved in regulating the amount and activity of a number of different proteins. Some types of cancer cells make too much of a histone deacetylase, which can cause the cancer to grow. HDAC inhibitors can prevent cancer cells from growing and dividing.

Remetinostat is a type of HDAC that is applied to the skin. A clinical trial is looking at how well it will work in treating people with basal cell carcinoma (NCT03180528).

Find out more about research in targeted therapy and research in immunotherapy.

Learn more about cancer research

Researchers continue to try to find out more about non-melanoma skin cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage non-melanoma skin cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for non-melanoma skin cancer were first shown to be effective through clinical trials.

Find out more about cancer research and clinical trials.

brachytherapy

A type of internal radiation therapy that places a sealed container of radiation substance (called an implant) to deliver radiation into a tumour or near a tumour.

basal cell nevus syndrome

An inherited condition that causes different problems with the skin, eye, nervous system, endocrine gland and jawbone. Basal cell nevus syndrome increases the risk of basal cell carcinoma skin cancer and a type of brain tumour called a medulloblastoma.

Also called Gorlin syndrome or nevoid basal cell carcinoma syndrome.

monoclonal antibody

A substance that can find and bind to a particular target molecule (antigen) on a cancer cell.

Monoclonal antibodies can interfere with a cell’s function or can be used to carry drugs, toxins or radioactive material directly to a tumour.

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