A review of emerging and non-US FDA-approved topical agents for the treatment of basal cell carcinoma.

ABSTRACT

Although surgical therapy continues to be the gold standard for the treatment of basal cell carcinoma given high cure rates and the ability to histologically confirm tumor clearance, there are a number of nonsurgical treatment options that may be considered based on individual tumor characteristics, functional and cosmetic considerations, patient comorbidities and patient preference. Topical 5-fluorouracil 5% cream and imiquimod 5% cream have been US FDA-approved for the treatment of superficial basal cell carcinoma. Additionally, a number of new and emerging topical agents and techniques have been described for the treatment of basal cell carcinoma and will be reviewed herein.

Lay abstract Treatment of basal cell carcinoma is important, as untreated tumors can grow and invade underlying tissue. Surgery has the highest cure rate for basal cell carcinoma. However, there are certain scenarios where surgery may not be appropriate or possible, and there are a number of nonsurgical treatment options. In cases of low-risk basal cell carcinoma where surgery is not appropriate, topical therapy is a potential treatment option. Topical 5-fluorouracil and imiquimod have been relatively well studied. There are a number of other topical agents that have been studied for basal cell carcinoma, with varying amounts of evidence. A number of these agents are still sold online despite having limited evidence of their safety and efficacy. This review will summarize the available literature on the proposed mechanisms of action, safety and efficacy of these topical agents. It is important to note that it is critical for patients to discuss their specific case with their treating healthcare provider to discuss treatment options that are appropriate in their particular situation.