Photodynamic therapy of multiple nonmelanoma skin cancers with verteporfin and red light-emitting diodes: two-year results evaluating tumor response and cosmetic outcomes.
BACKGROUND
Efficient treatment of patients with multiple synchronous nonmelanoma skin cancers represents a therapeutic challenge.


OBJECTIVE
To study the safety and efficacy of photodynamic therapy (PDT) with verteporfin and red light in the treatment of multiple nonmelanoma skin cancers.


METHODS
Open-label, randomized, multicenter, dose-ranging phase 2 study conducted at 4 North American university-based dermatology clinics.


METHODS
Fifty-four patients with 421 multiple nonmelanoma skin cancers including superficial and nodular basal cell carcinoma and squamous cell carcinoma in situ (Bowen disease).


METHODS
A single intravenous infusion of 14 mg/m(2) of verteporfin followed 1 to 3 hours later by exposure of tumors to 60, 120, or 180 J/cm(2) of red light (688 +/- 10 nm) from a light-emitting diode panel.


METHODS
Pathologic response of treated sites was assessed at 6 months. Clinical and cosmetic responses were assessed and graded at 6 weeks, 3 months, and 6 months after verteporfin PDT, with optional follow-up visits at 12, 18, and 24 months.


RESULTS
The histopathologic response, defined as absence of tumor on biopsy specimens 6 months after verteporfin PDT, ranged from 69% at 60 J/cm(2) to 93% at 180 J/cm(2). At 24 months of follow-up (276 tumors in 31 patients), the clinical complete response rate ranged from 51% at 60 J/cm(2) to 95% at 180 J/cm(2). No significant systemic adverse events were observed; most events occurred at the treated tumor sites and included events such as pain. Overall, 65% (95% confidence interval, 58%-71%) of tumors were judged to have good to excellent cosmesis at 24 months.


CONCLUSIONS
A single course of verteporfin PDT showed treatment benefit for patients with multiple nonmelanoma skin cancers.
Lui
Harvey
H
Division of Dermatology, University of British Columbia and Vancouver General Hospital, Vancouver, Canada. hlui@interchange.ubc.ca
Hobbs
Lori
L
Tope
Whitney D
WD
Lee
Peter K
PK
Elmets
Craig
C
Provost
Nathalie
N
Chan
Agnes
A
Neyndorff
Herma
H
Su
Xiang Yao
XY
Jain
Hem
H
Hamzavi
Iltefat
I
McLean
David
D
Bissonnette
Robert
R
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001913:Bowen's Disease / Q000188:drug therapy; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000188:drug therapy*; D000077362:Verteporfin
D000970:Antineoplastic Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin