Topical agents for preventing and treating actinic keratosis

Chaplin, Steve

doi:10.1002/psb.1451

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…15 Furthermore, diclofenac, fluorouracil, and imiquimod require a long duration of application from weeks to months. 16-18 Tirbanibulin is, therefore, favorable because of duration of treatment, safety profile, and ease of use. The one-time-use packets for a duration of 5 consecutive days may facilitate patient adherence and accountability.…”

Section: Relevance To Patient Care and Clinical Practicementioning

confidence: 99%

1% Tirbanibulin Ointment for the Treatment of Actinic Keratoses

Dao

Sahni

et al. 2021

Ann Pharmacother

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Objective Actinic keratoses (AKs) are cutaneous lesions that arise in sun-damaged skin. AKs may transform into squamous cell carcinoma in situ. Tirbanibulin 1% ointment is a new topical treatment for AKs, recently approved by the Food and Drug Administration. Data Sources The PubMed database was searched for articles published from 1960 to March 31, 2021, using the keywords tirbanibulin and Klisyri. Data Extraction Phase 2 and phase 3 clinical trials were reviewed. Data Synthesis In phase 2 clinical trials, 43% of patients treated with tirbanibulin experienced complete clearance by day 57 (43% [95% CI = 32, 54]). Across two phase 3 clinical trials (pooled data), complete (100%) clearance occurred in 49% of patients in tirbanibulin groups and in only 9% of the vehicle groups (difference, 41% points; 95% CI = 35 to 47; P < 0.001). Although no comparative studies are available, tirbanibulin is applied for a shorter duration (5 days) compared with diclofenac 3% gel, fluorouracil 5% cream, and imiquimod 3.75% cream. Adverse events were mild and included pruritus, application site pain, and local skin reactions. Systemic adverse events such as necrosis and angioedema, observed with other AK treatments such as fluorouracil and imiquimod, were not observed with tirbanibulin, thus giving tirbanibulin a favorable safety profile. Relevance to Patient Care and Clinical Practice Tirbanibulin effectively reduces AK burden and recurrence and has a favorable safety profile with mild adverse events. In comparison, imiquimod, 5-flourouracil, and diclofenac can result in necrosis, angioedema, and arthralgias. Conclusion With a favorable safety profile and short regimen, tirbanibulin is an efficacious treatment for clinicians to utilize in their treatment toolbox when treating AKs on the face and scalp.

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Section: Relevance To Patient Care and Clinical Practicementioning

confidence: 99%

1% Tirbanibulin Ointment for the Treatment of Actinic Keratoses

Dao

Sahni

et al. 2021

Ann Pharmacother

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“…However, such prolonged and complex treatments are usually associated with non-adherence and non-persistence to the prescribed treatment [ 28 ]. Additionally, these agents are chemically and pharmacologically different, with various related side effects ( Table 1 ) [ 29 ].…”

Section: Topical Field Treatmentsmentioning

confidence: 99%

“…Cancers 2020, 12, x 3 of 22 to the prescribed treatment [28]. Additionally, these agents are chemically and pharmacologically different, with various related side effects (Table 1) [29].…”

Section: Imiquimodmentioning

confidence: 99%

Regenerative Wound Dressings for Skin Cancer

Pavel

Chircov

Rădulescu

et al. 2020

Cancers

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Skin cancer is considered the most prevalent cancer type globally, with a continuously increasing prevalence and mortality growth rate. Additionally, the high risk of recurrence makes skin cancer treatment among the most expensive of all cancers, with average costs estimated to double within 5 years. Although tumor excision is the most effective approach among the available strategies, surgical interventions could be disfiguring, requiring additional skin grafts for covering the defects. In this context, post-surgery management should involve the application of wound dressings for promoting skin regeneration and preventing tumor recurrence and microbial infections, which still represents a considerable clinical challenge. Therefore, this paper aims to provide an up-to-date overview regarding the current status of regenerative wound dressings for skin cancer therapy. Specifically, the recent discoveries in natural biocompounds as anti-cancer agents for skin cancer treatment and the most intensively studied biomaterials for bioactive wound dressing development will be described.

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“…3 Treatment of SFC can decrease the risk of subsequent invasive skin cancer, 3−6 thereby avoiding the risk of spread and the need for subsequent lesion-focussed treatments with the consequent impact on quality of life and cost. 7 Current treatments of SFC such as topical 5-fluorouracil, imiquimod, ingenol mebutate and diclofenac gel, photodynamic therapy (PDT), and surgery are disappointing, 3,6,8,9 Radiotherapy (RT) can be used for treating invasive and in-situ or preinvasive skin cancer. 8 Advances in RT, especially volumetric modulated arc therapy (VMAT), 8,9,10 have enabled the delivery of highly conformal and homogenous radiation to large convex volumes like those usually involved in SFC 1,6,10 with reduced treatment times and greater sparing of normal tissue.…”

Section: Introductionmentioning

confidence: 99%

“…7 Current treatments of SFC such as topical 5-fluorouracil, imiquimod, ingenol mebutate and diclofenac gel, photodynamic therapy (PDT), and surgery are disappointing, 3,6,8,9 Radiotherapy (RT) can be used for treating invasive and in-situ or preinvasive skin cancer. 8 Advances in RT, especially volumetric modulated arc therapy (VMAT), 8,9,10 have enabled the delivery of highly conformal and homogenous radiation to large convex volumes like those usually involved in SFC 1,6,10 with reduced treatment times and greater sparing of normal tissue. 11−14 We report for the first time three cases of keratoacanthomas (KAs) arising in the regions treated with VMAT for SFC.…”

Section: Introductionmentioning

confidence: 99%

Keratoacanthomas following definitive volumetric modulated arc radiotherapy for skin field cancerization

Fogarty¹,

Mullin²,

Lochhead³

et al. 2019

IJRRT

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We describe three cases of keratoacanthomas (KAs) following definitive volumetric modulated arc therapy (VMAT) for skin field cancerisation (SFC). One lesion arose on a back in an area that had received a total of 30.6 Gy in 17 fractions. It first became apparent at 24 days post RT and resolved without treatment by 150 days. The other arose on a nasal alar in the beam penumbra that received 36Gy in 25 fractions, appearing at 57 days and resolving without treatment by 85 days. A third case occurred in an immunosuppressed patient. She developed KAs in one of two areas irradiated with lesions appearing at 21 days post RT and finally resolving at 300 days despite acitretin. The area received a total dose of 41.4 Gy in 23 fractions. Spontaneous resolution of index KA confirmed the diagnosis in all cases. On average, the patients were 79 years of age, the area bearing the KA had received an average of 36Gy in 22 fractions. The average onset of the KAs was 24 days or 3.5 weeks or one month after RT, and always soon after reepithelization was completed. Resolution was at an average of 168 days or 24 weeks or 6 months after the completion of RT. In all three cases other lesions arose adjacent to them and, in each case, one of these other lesions was excised with histopathology confirming squamo-proliferative lesions. There has been no recurrence at least 6 months after the last follow up. To our knowledge these are the first three cases of KA described following definitive VMAT for SFC. The possibility of KA arising after RT does need to be considered during the consent process.

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Topical agents for preventing and treating actinic keratosis

Cited by 5 publications

References 22 publications

1% Tirbanibulin Ointment for the Treatment of Actinic Keratoses

1% Tirbanibulin Ointment for the Treatment of Actinic Keratoses

Regenerative Wound Dressings for Skin Cancer

Keratoacanthomas following definitive volumetric modulated arc radiotherapy for skin field cancerization

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