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Interventions for Preventing Keratinocytic Cancer in Patients With A History of Previous Keratinocytic Carcinoma
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This systematic review analyzes the results of 18 prospective controlled trials to determine the safety and efficacy of existing therapies in preventing keratinocytic carcinoma (KC). Of all the studies that evaluated the efficacy of retinoids, only one demonstrated a slight benefit of oral retinol usage for the prevention of squamous cell carcinoma. Of the existing topical therapies, aminolevulinic acid-photodynamic therapy and 5-fluorouracil showed evidence of disease prevention. Among oral therapies, nicotinamide and celecoxib showed a reduction in the incidence of KCs.
- The available evidence regarding the chemoprevention of KC is heterogeneous with only a few therapies showing a significant benefit.
abstract
This abstract is available on the publisher's site.
Access this abstract nowKeratinocyte cancer (KC) is the most common cancer worldwide. It is important to analyze the actual interventions that are available for the prevention of patients with a previous history of a KC. We aim to review the existent literature to assess the efficacy and safety of interventions to prevent KC in patients with a history of previous KC. We searched clinical trials in which the main outcome was the prevention of KC in patients with a previous history of KC using the strategy published in the International Prospective Register of Systematic Reviews (PROSPERO registry), CRD42016045981. We analyzed 18 clinical trials from which eight reported a benefit with their respective intervention but had methodological flaws and a variable risk of bias. Two clinical trials (regarding celecoxib and oral supplementation with nicotinamide) seemed to have the most beneficial results reducing the incidence of KC in treated groups. However, all of the studies are highly heterogeneous, which does not allow a meta-analysis to be performed. New studies with greater epidemiological value should be conducted.
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Interventions for preventing keratinocytic cancer in patients with a history of a previous keratinocytic carcinoma: A systematic review
Int. J. Dermatol 2022 May 05;[EPub Ahead of Print], MJ García-Alonso, ML Peralta-Pedrero, F Jurado-Santa Cruz, MA Morales-SánchezFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
In this systematic review, Garcia-Alonso et al examined 18 clinical trials to assess the efficacy and safety of interventions in preventing keratinocyte cancers in patients with a history of them. The authors did not perform a meta-analysis, as the studies included are highly heterogeneous. Additionally, some of these studies have very small patient samples and short follow-up periods. However, from available data, nicotinamide and celecoxib therapies appear to be the most effective interventions, and nicotinamide is preferred potentially due to its safety profile, especially for the target population of older adults with comorbidities. Other interventions reviewed include oral retinoids, photodynamic therapy with aminolevulinic acid, 5-fluorouracil alone or in combination with calcipotriol, alpha-difluoromethylornithine, and a low-fat diet. However, additional studies are needed before specific recommendations can be made.