Basal Cell Carcinoma Treatment Reduces Tumor Size, Improves Surgical Removal

Basal cell carcinomas, the most prevalent type of skin cancer, often appear in areas exposed to the sun, such as the face. Locally advanced tumors, in particular, present challenges for surgical treatment. Now, a study published in Nature Cancer explored the effectiveness of a new therapy, yielding promising results. The treatment involved an active substance that led to tumor shrinkage in all participants, enhancing the effectiveness of surgical removal and, in some cases, resulting in complete tumor regression.

In the study, researchers from Medical University of Vienna (Vienna, Austria) used Talimogene Laherparepvec (TVEC), a treatment previously approved only for superficial melanoma metastases. TVEC is a genetically engineered herpes simplex virus designed to selectively destroy tumor cells while stimulating the immune system. The study aimed to reduce the tumor size prior to surgery, ensuring that patients would experience minimal functional or cosmetic limitations after the procedure. Eighteen patients with basal cell carcinoma, which would otherwise require a flap or skin graft due to its size and location, were given six intralesional injections of TVEC over 13 weeks before surgery.

The results were significant: half of the patients saw their tumors shrink sufficiently to allow for surgery with direct wound closure. In one-third of the cases, histological analysis post-surgery revealed no living tumor cells. All tumors treated with TVEC shrank, and none worsened during the therapy. The treatment was well tolerated by all patients. Additionally, the study included comprehensive analyses, demonstrating that TVEC therapy enhanced immune activity within the tumor tissue. These findings suggest that TVEC could serve as a promising neoadjuvant treatment for basal cell carcinoma, especially for patients who would benefit from avoiding major surgery. Further studies are planned to confirm the effectiveness of this approach in a broader patient group.

"The new treatment option for basal cell carcinoma can not only simplify surgery, but also help to avoid disfiguring operations and functional limitations," said first author Julia Ressler.