Neoadjuvant intralesional methotrexate in small‐sized cutaneous squamous cell carcinoma: a prospective study in 84 patients

Bergón‐Sendín, Marta; Pulido‐Pérez, Ana; Rosell‐Díaz, Ángel Manuel; Nieto‐Benito, Lula María; Suárez‐Fernández, R.

doi:10.1111/ajd.13520

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Indeed, in a prospective study by Bergón-Sendín et al with 10 patients with cSCC, 9 of which were located the lower lip, all showed a decrease in size with neoadjuvant ilMTX and 30% showed complete response [ 40 ]. This reduction in tumoral size with ilMTX has been observed in other studies [ 41 , 42 ]. A prospective study of 40 patients from the same group showed that ilMTX reduced not only tumor diameter (area) but also tumor thickness when evaluated with ultrasonography [ 43 ].…”

Section: Classic Treatmentssupporting

confidence: 88%

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Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma

Baeza-Hernández,

Cañueto

2023

Cancers

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Cutaneous squamous cell carcinoma (cSCC) is the second most frequent cancer in humans and has the potential to progress locally, metastasize, and cause death in a subset of patients. cSCC is especially common in the elderly, and it will probably represent a major health concern in the near future. Surgery is the standard treatment for cSCC, but intralesional therapies can sometimes be considered for certain patients and under certain circumstances. The choice of intralesional treatment depends on the patient′s characteristics and the clinician′s previous experience and expertise. Here we are reviewing intralesional treatments for cSCC and keratoacanthoma (KA). We have started with some classic drugs, such as methotrexate and 5-fluorouracil, bleomycin, interferon, and cryosurgery, but also comment on electrochemotherapy. Finally, we have focused on novel therapies, some of which are under development, and future perspectives, including intralesional immunotherapy and oncolytic viruses.

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Section: Classic Treatmentssupporting

confidence: 88%

“…Regarding ilMTX safety, no serious adverse events have been reported in the majority of the cases or studies published [ 7 , 8 , 9 , 10 , 38 , 39 , 40 , 41 , 42 , 43 , 46 ]. The most common secondary effects are mild local pain or erythema [ 8 , 39 , 40 , 42 ].…”

Section: Classic Treatmentsmentioning

confidence: 99%

Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma

Baeza-Hernández,

Cañueto

2023

Cancers

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“…In our study, the response rate is slightly lower than the reported in the above‐mentioned KA series, which can be justified because our study was conducted on cSCC. However, in another work performed by our group focused on small sized cSCC (≤15 mm), the response rate was 100% 11 …”

Section: Discussionmentioning

confidence: 87%

“…However, in another work performed by our group focused on small sized cSCC (≤15 mm), the response rate was 100%. 11 Most previous reports describe the occurrence or not of treatment response, categorizing the degree as "complete response" when that is the case. Non-significant (NS) differences = p>0,05; Significant differences = p<0,0001…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of neoadjuvant intralesional methotrexate in cutaneous squamous cell carcinoma: A prospective cohorts study

Bergón‐Sendín

Pulido‐Pérez

Nieto‐Benito

et al. 2021

Dermatologic Therapy

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Intralesional methotrexate (il-MTX) has been used in cutaneous squamous cell carcinoma (cSCC) achieving important reductions in tumor size. However, there is a lack of controlled studies on this regard. The primary objective was to analyze the effect of il-MTX on tumor size in cSCC. As a secondary objective, we evaluated its impact on the surgical approach. We conducted a prospective cohorts study that included 200 patients with histologically confirmed cSCC. Patients in Group 1 (Cases) received neoadjuvant treatment with il-MTX prior to surgery. Patients in Group 2 (Controls) underwent scheduled surgery without prior neoadjuvant therapy. Clinical measurements of lesions were made at the time of inclusion in the study and before surgery.No intergroup statistical differences were found between the assessed variables. In Group 1, tumor size reduction occurred in 93% of the patients after il-MTX therapy.Tumor surface was reduced by 54%. Complex reconstructions were needed in 15% of these patients. In Group 2, tumor surface increased by 33.1% and complex reconstructions were needed in 40% of patients. Intergroup differences were statistically significant (p < 0.001). Neoadjuvant Il-MTX therapy achieves very important tumor size reduction and significantly simplifies surgical treatment.

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“…Resolution rates appear correlated with lesion size, with clearance rates of approximately 71% for lesions < 15 mm in one study. 33 A separate analysis of interferon-alpha for SCCis reported a cure rate of 89% in nine patients. 34 This modality is generally applicable to patients at risk for slow wound healing or surgical complications, who desire to avoid surgery, and for lesions on cosmetically sensitive areas.…”

Section: Intralesional Chemotherapeuticsmentioning

confidence: 99%

Squamous Cell Carcinoma in Situ of the Nail Unit: Current Evidence and Recommendations for Patient Centered Treatment

et al. 2022

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Squamous cell carcinoma in situ of the hand and nail is an infrequent tumor but represents the majority of hand and nail malignancies. While the conventional treatments of invasive nail unit squamous cell carcinoma include Mohs micrographic surgery, wide local excision, or distal digit amputation, no standardized management paradigm for in situ disease exists and the necessity of surgical options is debated. This review aims to discuss the most commonly reported treatment methods and critically assess relevant management considerations in order to facilitate appropriate treatment decisions for nail unit SCCis across dermatologic practice settings. Assessment of the current literature reveals insufficient evidence to determine a standardized treatment for nail unit squamous cell carcinoma in situ. Rather, management is greatly impacted by multiple factors including the presence of subungual involvement, surgical candidacy, importance of curative treatment, and patient preferences regarding cosmesis and function versus cure. When cure is desired, Mohs micrographic surgery is the treatment of choice in most cases. In the setting of desired curative intent, but poor surgical candidacy, radiotherapy may be effective and provide a reasonable chance of functional and cosmetic preservation. Other methods including photodynamic therapy, electrodesiccation and curettage, cryotherapy, and intralesional chemotherapeutics may be appropriate in specific circumstances, but are generally limited by lack of evidence or impracticalities. Lastly, observation with palliation may be appropriate when considering exceedingly rare disease-related mortality.

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Neoadjuvant intralesional methotrexate in small‐sized cutaneous squamous cell carcinoma: a prospective study in 84 patients

Cited by 5 publications

References 10 publications

Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma

Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma

Effectiveness of neoadjuvant intralesional methotrexate in cutaneous squamous cell carcinoma: A prospective cohorts study

Squamous Cell Carcinoma in Situ of the Nail Unit: Current Evidence and Recommendations for Patient Centered Treatment

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