Squamous cell carcinoma is the second most common skin cancer, affecting nearly 700,000 people each year in the U.S. Many cases are preceded by rough, scaly patches on the skin called actinic keratoses (AK). Although many people with AK never develop skin cancer, it’s standard to treat all cases of AK to prevent cancer.
“While we know that some actinic keratoses will progress to squamous cell carcinoma, there is no way to predict which ones will or when,” says Ronald Davis, MD, a dermatologist and assistant program director of the Tulane University School of Medicine in New Orleans.
Treatment for AK can include surgery, freezing, creams or photodynamic therapy, a type of light therapy that can span several days.
In late January, a new therapy was approved called Picato (ingenol mebutate), a topical gel that works in just a few days. Ingenol mebutate is the active agent in the sap of the plant Euphorbia peplus, a traditional remedy used for skin lesions. The gel was tested in several phase 3 studies and showed more patients with AK treated with Picato had complete disappearance of the precancerous lesions, although it can cause temporary redness, dryness and swelling. Long-term efficacy and impact on preventing cancer is still unknown.
“Many patients have dozens or even hundreds of these lesions, so being able to treat them all, over a period of a few days, is a significant advance over currently available therapies,” Davis says. “I look forward to evaluating this in my clinical practice and assessing the results in comparison with treatments I presently use.”