Promising Topical Therapy for Actinic Keratoses - Brief Article

0 Comments | Family Practice News, Dec 1, 2000 | by Nancy Walsh

GENEVA -- Basal cell skin cancers could be treated medically if a new topical preparation continues to show good results.

The topical preparation, called Bec-5, is licensed in Australia for the treatment of actinic keratoses. In a study conducted at 10 centers in the United Kingdom, 54 men and 44 women, ranging in age from 32 to 95 years, were randomized in a 2:1 ratio to treatment with Bec-5 or with the same topical preparation without the Bec-5 for 8 weeks. All had biopsy-proved, primary basal cell carcinomas that had been present for no longer than 1 year.

Dr. Sangeeta Punjabi of the Royal London Hospital presented the Bec-5 study findings at the ninth Congress of the European Academy of Dermatology and Venereology. Bec-5 is a mixture of 0.005% solasodine glycosides that are found in solanaceous plants such as eggplant. The glycosides bind to endogenous lectins and are preferentially toxic to human cancer cells.

Patients applied the Bec-5 or vehicle creams twice daily to the lesions and covered them with occlusive dressings. Patients were monitored every 2 weeks for adverse effects and overall response, and a final biopsy at the end of the treatment period determined whether the tumor had successfully cleared.

At the end of the 8-week treatment period, the lesions had cleared in 66% of the 62 patients who received Bec-5, compared with 25% of the 32 patients in the control group. "This was a highly significant difference," Dr. Punjabi said.

Ten patients in the treatment group withdrew from the study during the 8week treatment phase. Two had failed to follow the study protocol; seven had adverse effects such as pruritus, irritation, and pain; and one patient died of unrelated causes. None of those patients in the control group withdrew due to adverse effects, but one patient died of unrelated causes.

The study participants were observed at two 6-month intervals. After 1 year, 52% of the active treatment group and 16% of the control group remained tumor free.

"We did not see any untoward effects on liver, kidney, or hemopoietic systems, and cosmetic results were satisfactory," Dr. Punjabi said.

Basal cell carcinomas are typically excised, curerted, or cryosurgically treated. Topical treatment with 5-fluorouracil has been previously attempted, but it was found to be associated with subsequent tumor spread beneath the healed epidermis and is not recommended.

Further studies with Bec-5 are planned, Dr. Punjabi said. These will address whether certain types of basal cell carcinomas are more likely to respond to the preparation, which is marketed as Curaderm in Australia.