Estratégias de quimioprevenção do câncer de pele não melanoma.

Conteúdo do artigo principal

Lizandra Machado Santos
Eduarda Klockner
Mateus Rodrigues de Aguiar
Gustavo Yano Callado
Heitor Carvalho Gomes
Renato Santos de Oliveira Filho

Resumo

A incidência do câncer de pele não melanoma (CPNM) vem aumentando no mundo todo. Buscando reduzir a incidência e a morbidade desses tumores, diversas estratégias de prevenção vêm sendo estudadas. A quimioprevenção do CPNM baseia-se no conceito de que tratamentos tópicos ou sistêmicos podem prevenir a progressão de lesões precursoras de carcinomas invasivos, estando direcionada a pacientes com alto risco de desenvolver esses tipos de cânceres. O presente artigo tem por objetivo revisar as substâncias tópicas e sistêmicas mais estudadas, atualmente, como estratégias de quimioprevenção para o CPNM. Esta revisão de literatura selecionou artigos e publicações relativas às terapêuticas tópicas e sistêmicas para a quimioprevenção do CPNM, publicados em inglês ou português, entre os anos de 2005 e 2022. As bases de dados utilizadas foram MEDLINE e LILACS. De cada artigo selecionado foram extraídas informações, que foram compiladas em uma planilha de análise, a qual foi utilizada para redigir a presente revisão. De acordo com os artigos selecionados, a quimioprevenção ao CPNM pode ser feita tanto por via tópica como por via oral. Dentre as modalidades tópicas destacam-se: a terapia fotodinâmica, o 5-fluorouracil (5-FU), o imiquimode e o diclofenaco de sódio. As substâncias sistêmicas mais relevantes, por sua vez, são a nicotinamida, os retinóides orais e os inibidores da ciclooxigenase. Esta revisão possibilitou concluir que a quimioprevenção do CPNM deve ser considerada em pacientes de alto risco. Contudo, mais estudos são necessários para complementar as evidências dos agentes quimiopreventivos para a prevenção de CPNM.

Detalhes do artigo

Como Citar
1.
Machado Santos L, Klockner E, Rodrigues de Aguiar M, Yano Callado G, Carvalho Gomes H, Santos de Oliveira Filho R. Estratégias de quimioprevenção do câncer de pele não melanoma. Braz. J. Nat. Sci [Internet]. 24º de setembro de 2022 [citado 24º de fevereiro de 2024];4(3):E1582022, 1-9. Disponível em: https://bjns.com.br/index.php/BJNS/article/view/158
Seção
Artigo de revisão em fluxo contínuo
Biografia do Autor

Lizandra Machado Santos , Universidade Federal da São Paulo - UNIFESP

Discente do Mestrado Profissional em Ciência, Tecnologia e Gestão Aplicados à Regeneração Tecidual da UNIFESP. Dermatologista.

Eduarda Klockner, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS

Acadêmica de medicina na Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS. 

Mateus Rodrigues de Aguiar, Universidade Federal do Ceará - UFC

Acadêmico de Medicina da Universidade Federal do Ceará. 

Gustavo Yano Callado, Faculdade Israelita de Ciências da Saúde Albert Einstein - FICSAE

Acadêmico de Medicina da Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE). 

Heitor Carvalho Gomes, Universidade Federal da São Paulo - UNIFESP

Docente do Mestrado Profissional em Ciência, Tecnologia e Gestão Aplicados à Regeneração Tecidual da UNIFESP. Cirurgião Plástico. 

Renato Santos de Oliveira Filho , Universidade Federal da São Paulo - UNIFESP

Professor adjunto e coordenador do Setor de Melanoma e Tumores Cutâneos da Disciplina de Cirurgia Plástica da Unifesp, professor orientador do Mestrado Profissional em Ciência, Tecnologia e Gestão Aplicados à Regeneração Tecidual da Unifesp. Cirurgião Oncológico. 

Referências

Amini S, Viera MH, Valins W, Berman B. Nonsurgical innovations in the treatment of nonmelanoma skin cancer. J Clin Aesthet Dermatol. 2010;3(6):20-34.

Arab KA, AlRuhaili A, AlJohany T, AlHammad RS. Melanoma and non-melanoma skin cancer among patients who attended at King Khalid University Hospital in Riyadh, Saudi Arabia from 2007 - 2018. Saudi Med J. 2020;41(7):709-714. doi:10.15537/smj.2020.7.25138.

Azin M, Mahon AB, Isaacman S, Seaman JE, Allen IE, Szarek M, et al. Topical Calcipotriol Plus 5-Fluorouracil Immunotherapy for Actinic Keratosis Treatment. JID Innov. 2022;2(3):100104.

Bajalia EM, Azzouz FB, Chism DA, et al. Phytochemicals for the Prevention and Treatment of Renal Cell Carcinoma: Preclinical and Clinical Evidence and Molecular Mechanisms. Cancers (Basel). 2022;14(13):3278. Published 2022 Jul 4. doi:10.3390/cancers14133278.

Batista FC, Suzuli VY, Gomes HC, Oliveira Filho RS, Ferreira LM. Nutrição na prevenção do câncer de pele. 1ª Ed. São Paulo. 2020.

Blauvelt A, Tsai TF, Langley RG, Miller M, Shen YK, You Y, et al. Consistent safety profile with up to 5 years of continuous treatment with guselkumab: Pooled analyses from the phase 3 VOYAGE 1 and VOYAGE 2 trials of patients with moderate-to-severe psoriasis. J Am Acad Dermatol. 2022;86(4):827-834.

Bocoli KH, Veiga DF, Cabral IV, Carvalho MPD, Novo NF, Veiga Filh J, et al. Tratamento cirúrgico de carcinomas cutâneos pelo Sistema Único de Saúde: análise de custos. Revista do Colégio Brasileiro de Cirurgiões. 2013; 40, 449-452.

Bubna AK. Imiquimod - Its role in the treatment of cutaneous malignancies. Indian J Pharmacol. 2015;47(4):354-9.

Butler GJ, Neale R, Green AC, Pandeya N, Whiteman DC. Nonsteroidal anti-inflammatory drugs and the risk of actinic keratoses and squamous cell cancers of the skin. J Am Acad Dermatol. 2005;53(6):966-72.

Calzavara-Pinton P, Calzavara-Pinton I, Rovati C, Rossi M. Topical Pharmacotherapy for Actinic Keratoses in Older Adults. Drugs Aging. 2022;39(2):143-152.

Camp WL, Turnham JW, Athar M, Elmets CA. New agents for prevention of ultraviolet-induced nonmelanoma skin cancer. Semin Cutan Med Surg. 2011;30(1):6-13. doi:10.1016/j.sder.2011.01.003.

Chen AC, Martin AJ, Choy B, Fernandez-Peñas P, Dalziell RA, McKenzie CA, et al. A Phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention. The New England Journal of Medicine. 2015; 373: 1618-1626. DOI: 10.1056/NEJMoa1506197.

Cornejo CM, Jambusaria-Pahlajani A, Willenbrink TJ, Schmults CD, Arron ST, Ruiz ES. Field cancerization: Treatment. J Am Acad Dermatol. 2020 Sep;83(3):719-730. doi: 10.1016/j.jaad.2020.03.127. Epub 2020 May 6. PMID: 32387663.

Cunningham TJ, Tabacchi M, Eliane JP, Tuchayi SM, Manivasagam S, Mirzaalian H, et al. Randomized trial of calcipotriol combined with 5-fluorouracil for skin cancer precursor immunotherapy. J Clin Invest. 2017;127(1):106-116.

Damian, DL. Nicotinamide for skin cancer chemoprevention. Australian Journal of Dermatology. 2017(58): 174-180. doi: 10.1111/ajd.12631.

Del Regno L, Catapano S, Di Stefani A, Cappilli S, Peris K. A Review of Existing Therapies for Actinic Keratosis: Current Status and Future Directions. Am J Clin Dermatol. 2022; 23(3):339-352. https://doi.org/10.1007/s40257-022-00674-3.

Dianzani C, Conforti C, Giuffrida R, Corneli P, di Meo N, Farinazzo E, et al. Current therapies for actinic keratosis. International Journal of Dermatology, v. 59, n. 6, p. 677-684, 2020. doi: 10.1111/ijd.14767.

Elmets CA, Viner JL, Pentland AP, Cantrell W, Lin H-Y, Bailey H, et al. Chemoprevention of nonmelanoma skin cancer with celecoxib: A randomized, double-blind, placebo-controlled trial. JNCI: Journal of the National Cancer Institute. 2010;102(24):1835–44.

Fania L, Didona D, Di Pietro FR, Verkhovskaia S, Morese R, Paolino G, et al. Cutaneous Squamous Cell Carcinoma: From Pathophysiology to Novel Therapeutic Approaches. Biomedicines. 2021;9(2):171. doi:10.3390/biomedicines9020171.

Figueras Nart I, Cerio R, Dirschka T, Dréno B, Lear JT, Pellacani G, et al. Defining the actinic keratosis field: A literature review and discussion. Journal of the European Academy of Dermatology and Venereology. 2017;32(4):544–63.

Guerra KC, Zafar N, Crane JS. Skin Cancer Prevention. [Updated 2021 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.

Gupta AK, Paquet M, Villanueva E, Brintnell W. Interventions for actinic keratoses. Cochrane Database Syst Rev. 2012;12(12):CD004415.

Guy GP Jr, Machlin SR, Ekwueme DU, Yabroff KR. Prevalence and costs of skin cancer treatment in the U.S., 2002-2006 and 2007-2011. Am J Prev Med. 2015;48(2):183-187. doi:10.1016/j.amepre.2014.08.036.

Huang A, Nguyen JK, Austin E, Mamalis A, Jagdeo J. Updates on Treatment Approaches for Cutaneous Field Cancerization. Curr Dermatol Rep. 2019;8(3):122-132.

Ianhez M, Fleury LFF Jr, Miot HA, Bagatin E. Retinoids for prevention and treatment of actinic keratosis. An Bras Dermatol. 2013;88(4):585-93. doi: 10.1590/abd1806-4841.20131803.

INCA. Instituto Nacional de Câncer. Câncer de pele não melanoma. Disponível em: . Acesso em 03 ago 2022.

Jarvis B, Figgitt DP. Topical 3% diclofenac in 2.5% hyaluronic acid gel: a review of its use in patients with actinic keratoses. Am J Clin Dermatol. 2003;4(3):203-13.

Johannesdottir SA, Chang ET, Mehnert F, Schmidt M, Olesen AB, Sørensen HT. Nonsteroidal anti-inflammatory drugs and the risk of skin cancer: a population-based case-control study. Cancer. 2012;118(19):4768-76.

Lopes LL, Lopes LRS. Tratamento do campo de cancerização cutâneo. Surgical & Cosmetic Dermatology, vol. 11, núm. 3, pp. 187-194, 2019.

Lopez AT, Carvajal RD, Geskin L. Secondary Prevention Strategies for Nonmelanoma Skin Cancer. Oncology (Williston Park). 2018 Apr 15;32(4):195-200. PMID: 29684233.

Ma Y, Yu P, Lin S, Li Q, Fang Z, Huang Z. The association between nonsteroidal

anti-inflammatory drugs and skin cancer: Different responses in American and

European populations. Pharmacol Res. 2020 Feb;152:104499. doi:

1016/j.phrs.2019.104499. Epub 2019 Nov 2. PMID: 31689521.

Mantena SK, Roy AM, Katiyar SK. Epigallocatechin-3-Gallate Inhibits Photocarcinogenesis Through Inhibition of Angiogenic Factors and Activation of CD8+ T Cells in Tumors. Photochemistry and Photobiology. 2005; 81: 1174-1179. Photochem Photobiol. 2018;94(3):618.

Morton CA, McKenna KE, Rhodes LE. British Association of Dermatologists Therapy Guidelines and Audit Subcommittee and the British Photodermatology Group. Guidelines for topical photodynamic therapy: update. Br J Dermatol. 2008 Dec;159(6):1245-66. doi: 10.1111/j.1365-2133.2008.08882.x. Epub 2008 Oct 13. PMID: 18945319.

Morton CA, Szeimies RM, Basset-Séguin N, Calzavara-Pinton PG, Gilaberte Y, Haedersdal M, et al. European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 2: emerging indications - field cancerization, photorejuvenation and inflammatory/infective dermatoses. J Eur Acad Dermatol Venereol. 2020;34(1):17-29.

Nemer KM, Council ML. Topical and systemic modalities for chemoprevention of nonmelanoma skin cancer. Dermatologic Clinics. 2019;37(3):287–95.

O'Reilly Zwald F, Brown M. Skin cancer in solid organ transplant recipients: advances in therapy and management: part II. Management of skin cancer in solid organ transplant recipients. J Am Acad Dermatol. 2011;65(2):263-279.

Otley CC, Stasko T, Tope WD, Lebwohl M. Chemoprevention of nonmelanoma skin cancer with systemic retinoids: practical dosing and management of adverse effects. Dermatol Surg. 2006;32(4):562-8.

Ozog DM, Rkein AM, Fabi SG, Gold MH, Goldman MP, Lowe NJ, et al. Photodynamic Therapy: A Clinical Consensus Guide. Dermatol Surg. 2016 Jul;42(7):804-27. doi: 10.1097/DSS.0000000000000800. Erratum in: Dermatol Surg. 2017 Feb;43(2):319. PMID: 27336945.

Que SKT, Zwald FO, Schmults CD. Cutaneous squamous cell carcinoma: Incidence, risk factors, diagnosis, and staging. J Am Acad Dermatol. 2018;78(2):237-247. doi:10.1016/j.jaad.2017.08.059.

Reinehr CP, Bakos RM. Actinic keratoses: Review of Clinical, dermoscopic, and therapeutic aspects. Anais Brasileiros de Dermatologia. 2019;94(6):637–57.

Rivers JK, Arlette J, Shear N, Guenther L, Carey W, Poulin Y. Topical treatment of actinic keratoses with 3.0% diclofenac in 2.5% hyaluronan gel. Br J Dermatol. 2002;146(1):94-100.

Rosenberg AR, Tabacchi M, Ngo KH, Wallendorf M, Rosman IS, Cornelius LA, et al. Skin cancer precursor immunotherapy for squamous cell carcinoma prevention. JCI Insight. 2019;4(6):e125476.

Schauder DM, Kim J, Nijhawan RI. Evaluation of the Use of Capecitabine for the Treatment and Prevention of Actinic Keratoses, Squamous Cell Carcinoma, and Basal Cell Carcinoma: A Systematic Review. JAMA Dermatol. 2020;156(10):1117–1124. doi:10.1001/jamadermatol.2020.2327.

Smit JV, Sévaux RGL, Blokx WAM, van de Kerkhof PCM, Hoitsma AJ, Jong EMGJ. Acitretin treatment in (pre) malignant skin disorders of renal transplant recipients: histologic and immunohistochemical effects. Journal of the American Academy of Dermatology. 2004; 50(2):189-196. DOI: https://doi.org/10.1016/S0190-9622(03)01837-1.

Smith SR, Bilateral comparison of the efficacy and tolerability of 3% diclofenac sodium gel and 5% 5-fluorouracil cream in the treatment of actinic keratoses of the face and scalp. J Drugs Dermatol. 2006 Feb;5(2):156-9. PMID: 16485883.

Snaidr VA, Damian DL, Halliday GM. Nicotinamide for photoprotection and skin cancer chemoprevention: A review of efficacy and safety. Exp Dermatol. 2019;28:15-22. https://doi.org/10.1111/exd.13819.

Surjana D, Halliday GM, Martin AJ, Moloney FJ, Damian DL. Oral nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials. J Invest Dermatol. 2012;132(5):1497-1500. doi:10.1038/jid.2011.459.

Szeimies RM, Torezan L, Niwa A, Valente N, Unger P, Kohl E, et al. Clinical, histopathological and immunohistochemical assessment of human skin field cancerization before and after photodynamic therapy. Br J Dermatol. 2012;167(1):150-9.

Szymański Ł, Skopek R, Palusińska M, Schenk T, Stengel S, Lewicki S, et al. Retinoic Acid and Its Derivatives in Skin. Cells. 2020; 9(12):2660. https://doi.org/10.3390/cells9122660.

Swanson N, Smith CC, Kaur M, Goldenberg G. Imiquimod 2.5% and 3.75% for the treatment of actinic keratoses: two phase 3, multicenter, randomized, double-blind, placebo-controlled studies. J Drugs Dermatol. 2014;13(2):166-9.

Thomas GJ, Herranz P, Cruz SB, Parodi A. Treatment of actinic keratosis through inhibition of cyclooxygenase-2: Potential mechanism of action of diclofenac sodium 3% in hyaluronic acid 2.5. Dermatol Ther. 2019;32(3):e12800.

Ulrich M, Pellacani G, Ferrandiz C, Lear JT. Evidence for field cancerisation treatment of actinic keratoses with topical diclofenac in hyaluronic acid. Eur J Dermatol. 2014;24(2):158-67.

Vidal D. Topical imiquimod: mechanism of action and clinical applications. Mini Rev Med Chem. 2006;6(5):499-503.

Zhang P, Han T, Xia H, Dong L, Chen L, Lei L. Advances in Photodynamic Therapy Based on Nanotechnology and Its Application in Skin Cancer. Front Oncol. 2022;12:836397.

Wan MT, Lin JY. Current evidence and applications of photodynamic therapy in dermatology. Clin Cosmet Investig Dermatol. 2014;7:145-63.

Weinstock MA, Thwin SS, Siegel JA, Marcolivio K, Means AD, Leader NF, et al. Chemoprevention of Basal and Squamous Cell Carcinoma With a Single Course of Fluorouracil, 5%, Cream: A Randomized Clinical Trial. JAMA Dermatol. 2018;154(2):167-174.

Werner RN, Stockfleth E, Connolly SM, Correia O, Erdmann R, Foley P, et al. Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version. J Eur Acad Dermatol Venereol. 2015;29(11):2069-79.

Wong TH, Morton CA, Collier N, Haylett A, Ibbotson S, McKenna KE, et al. British Association of Dermatologists and British Photodermatology Group guidelines for topical photodynamic therapy 2018. Br J Dermatol. 2019;180(4):730-739.

Wright TI, Spencer JM, Flowers FP. Chemoprevention of nonmelanoma skin cancer. Journal of the American Academy of Dermatology. 2006, 54 (6): 933-946. https://doi.org/10.1016/j.jaad.2005.08.062

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