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 non-melanoma skin cancer. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year. You can find information about ongoing clinical trials in Canada from CanadianCancerTrials.ca and ClinicalTrials.gov. Clinical trials are given an identifier called a national clinical trial (NCT) number. The NCT number links to information about the clinical trial.
Preventing non-melanoma skin cancer
Researchers look at substances or behaviours that might prevent non-melanoma skin cancer or lower the risk of developing it. They may study people who eat certain foods, take certain drugs or vitamin supplements or do physical activity to see if they develop non-melanoma skin cancer less often than people with different habits.
Nicotinamide, a form of vitamin B3, seems to protect against the damaging effects of ultraviolet (UV) radiation. An Australian phase III trial studied nicotinamide in people who had non-melanoma skin cancer in the past. They took this drug by mouth (orally) twice daily. Results show that the people who took nicotinamide developed a new non-melanoma skin cancer less often than those who took a placebo. They also show that people who took nicotinamide were less likely to develop actinic keratosis, which is a precancerous skin condition. More research is needed to understand if nicotinamide can help prevent actinic keratosis and non-melanoma skin cancer in different populations (The New England Journal of Medicine, PMID 26488693; ASCO, Abstract 9000).
Alpha-difluoromethylornithine (DFMO) is a drug that lowers the activity of the enzyme ornithine decarboxylase. This enzyme helps cells grow and is often very active in cancer cells. Lowering the activity of this enzyme may help stop the growth of cancer cells. Diclofenac (Voltaren) is a nonsteroidal anti-inflammatory drug (NSAID). Topical diclofenac is used to relieve pain. Researchers believe diclofenac also has anticancer properties. They are studying using topical DFMO along with diclofenac cream to see if the combination of these 2 drugs is more effective in preventing non-melanoma skin cancer than either drug alone (Cancer Prevention Research, PMID 26712942; ClinicalTrials.gov, NCT02636569). Topical diclofenac also shows promise as a possible new treatment for superficial basal cell carcinoma (Journal of the American Academy of Dermatology, PMID 27067393).
TPF 50 is a new product that is applied to the skin. When TPF 50 was used along with sunscreen in a clinical trial, it improved the integrity of skin cells exposed to UV radiation. In turn, this may reduce the damaging effects of UV radiation and could possible lower the risk of developing non-melanoma skin cancer (Journal of Drugs in Dermatology, PMID 24595577).
Tips about sun protection and skin self-examination can help improve behaviours that prevent non-melanoma skin cancer. A clinical trial called the Healthy Texts Study found that texting these types of tips to participants improved people’s behaviours and may help prevent non-melanoma skin cancer (Preventive Medicine, PMID 25524612; Contemporary Clinical Trials, PMID 23557730; Journal of Telemedicine and Telecare, PMID 25697490).
Find out more about research in cancer prevention.
Diagnosis and prognosis
A key area of research looks at better ways to diagnose non-melanoma skin cancer and follow-up after treatment. The following is noteworthy research into some new imaging techniques that may help doctors diagnose, plan treatment and monitor response to treatment for non-melanoma skin cancer.
Optical coherence tomography (OCT) uses light waves to make pictures of the skin. Studies show that finding basal cell carcinoma (BCC) and actinic keratosis is easier when OCT is used along with clinical skin exam and dermoscopy. OCT is also helpful in checking response to treatment and finding any cancer that remains after treatment with topical medicines and photodynamic therapy (British Journal of Dermatology, PMID 25904111; Skin Research and Technology, PMID 26804618; Photodiagnosis and Photodynamic Therapy, PMID 27519350).
Reflectance confocal microscopy (RCM) is an imaging technique that uses a special microscope and beams of laser light to look at the layers of the skin. Studies found that RCM seems to be an accurate diagnostic tool for skin cancer, including BCC. Studies are looking at whether RCM is as good at diagnosing the subtype of BCC as conventional techniques (Journal of the European Academy of Dermatology and Venereology, PMID 27230832, PMID 28370434; JMIR Research Protocols, PMID 27363577; JAMA Dermatology, PMID 25993262, PMID 27580185; Lasers in Medical Science, PMID 27492373; The Journal of Dermatological Treatment, PMID 26325338; International Journal of Dermatology, PMID 27419915; The British Journal of Dermatology, PMID 28391599).
Find out more about research in diagnosis and prognosis.
Researchers are looking for new ways to improve treatment for non-melanoma skin cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for non-melanoma skin cancer.
Laser treatment uses a laser (an intense beam of light) to remove tissue. Researchers are studying laser light as a possible treatment for non-melanoma skin cancer (Lasers in Surgery and Medicine, PMID 25645536; British Journal of Dermatology, PMID 25040296; ClinicalTrials.gov, NCT02662244).
Laser-mediated photodynamic therapy (PDT)
PDT is a treatment that uses drugs called photosensitizers that can destroy cancer cells when they are exposed to light. Laser-mediated PDT is a newer procedure that uses a laser light source to activate the photosensitizer. It may be more effective than conventional PDT. Researchers are looking at whether laser-mediated PDT may be a suitable treatment option for non-melanoma skin cancers compared to conventional treatments (British Journal of Dermatology, PMID 24903544; Photodiagnosis and Photodynamic Therapy, PMID 27516420; Journal of the European Academy of Dermatology and Venereology, PMID 26551044; JAMA Dermatology, PMID 28199463).
Brachytherapy is a type of radiation therapy that uses a radioactive substance placed directly on, into or near a tumour. Different types of applicators, such as molds, flat mats and needles, are used to give brachytherapy on the surface of the skin. A few centres in Canada use brachytherapy to treat non-melanoma skin cancer, but more research is needed to find out the best dose and schedule (Brachytherapy, PMID 27908679, PMID 26489922).
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. Researchers are studying electronic brachytherapy as a treatment for non-melanoma skin cancer (Practical ClinicalTrials.gov, NCT02131805; Journal of Contemporary Brachytherapy, PMID 25834587; The Journal of Clinical and Aesthetic Dermatology, PMID 26705437, PMID 28210385; Practical Radiation Oncology, PMID 26432680; JAMA Dermatology, PMID 26267892).
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.
Epidermal growth factor receptor (EGFR) inhibitors
EGFR inhibitors target the EGFR proteins on the surface of cells. EGFR sends signals to cells that allow them to grow and divide. EGFR inhibitors stop EGFR from working, which stops or slows the growth of cancer cells. The following are some EGFR inhibitors being studied as treatment for squamous cell carcinoma (SCC).
Cetuximab (Erbitux) may be a treatment option for advanced or aggressive SCC. Small studies found that giving cetuximab alone or with chemotherapy helped control SCC that has grown into nearby tissues (called locally advanced disease) and SCC that can’t be removed by surgery (called unresectable disease). A clinical trial is giving cetuximab before surgery to find out if it can shrink the tumour and reduce the amount of healthy tissue that needs to be removed (Journal of Dermatological Treatment, PMID 23167307; British Journal of Dermatology, PMID 25704233; ClinicalTrials.gov, NCT02324608).
Erlotinib (Tarceva) and gefitinib (Iressa) may be treatment options for SCC that has come back or spread to other parts of the body. Researchers are currently studying these drugs (ClinicalTrials.gov, NCT01198028, NCT00054691, NCT00126555).
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. Vismodegib (Erivedge) is one of these types of drugs that is currently used to treat BCC. Researchers are studying the following hedgehog pathway inhibitor as treatment for different stages of BCC.
Sonidegib (Odomzo) may be a new treatment option for locally advanced or metastatic BCC. An early clinical trial found that tumours had a response to sonidegib (The Lancet Oncology, PMID 25981810; Journal of the American Academy of Dermatology, PMID 27067394; Clinical Cancer Research, PMID 26546616).
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) may be a treatment option for advanced BCC. Researchers are studying this drug alone and with vismodegib to see how well it controls the growth of BCC that can’t be removed with surgery or has spread to other parts of the body (ClinicalTrials.gov, NCT02690948). They are also doing clinical trials to see if pembrolizumab can treat Merkel cell carcinoma (New England Journal of Medicine, PMID 27093365).
Find out more about research in targeted therapy.
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.
A harmless, inactive substance or treatment that looks the same as, and is given in the same way as, an active drug or treatment.
Placebos may be used in controlled clinical trials. One group is given a placebo and the other is given the substance or treatment being studied, then researchers compare the effects of the placebo and the active substance or treatment.
Referring to a reaction or improvement related to treatment.
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The latest Canadian Cancer Statistics report shows about half of Canadians are expected to be diagnosed with cancer in their lifetime.