Non-melanoma skin cancer chemoprevention strategies.
Article Sidebar
Main Article Content
Abstract
The incidence of non-melanoma skin cancer (NMSC) is increasing worldwide. Seeking to reduce the incidence and morbidity of these tumors, several prevention strategies have been studied. NMSC chemoprevention is based on the concept that topical or systemic treatments can prevent the progression of precursor lesions of invasive carcinomas, being aimed at patients at high risk of developing these types of cancers. This article aims to review the topical and systemic substances that are currently most studied as chemoprevention strategies for NMSC. This literature review selected articles and publications related to topical and systemic therapies for the chemoprevention of NMSC, published in English or Portuguese, between 2005 and 2022. The databases used were MEDLINE and LILACS. Information was extracted from each selected article, which was compiled into an analysis worksheet, which was used to write this review. According to the selected articles, NMSC chemoprevention can be performed either topically or orally. Among the topical modalities, the following stand out: photodynamic therapy, 5-fluorouracil (5-FU), imiquimod and sodium diclofenac. The most relevant systemic substances, in turn, are nicotinamide, oral retinoids and cyclooxygenase inhibitors. This review made it possible to conclude that NMSC chemoprevention should be considered in high-risk patients. However, more studies are needed to complement the evidence of chemopreventive agents for the prevention of NMSC.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Statement - Policy Proposal for Open Access Journals
Authors who publish in the Brazilian Journal of Natural Sciences (BJNS) agree to the following terms: 1 - Authors retain the copyright and grant the journal the right to first publication, with the work simultaneously licensed under the Creative Commons Attribution License allowing sharing of the work with recognition of the authorship of the work and initial publication in this journal. 2 - Authors are authorized to assume additional contracts separately, for non-exclusive distribution of the version of the work published in this journal (eg, publishing in institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal. 3 - Authors are allowed and encouraged to publish and distribute their work online (eg in institutional repositories or on their personal page) at any point before or during the editorial process, as this can generate productive changes, as well as increase the impact and citation of published work. This is an open access article under the CC-BY license
(http://creativecommons.org/licenses/by/4.0)
References
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