Topical Ingenol Mebutate: A New Treatment Modality for Multiple Actinic Keratoses and Field Cancerization

Kostović, Krešimir; Gulin, Sandra Jerković; Mokoš, Zrinka Bukvić; Čeović, Romana

doi:10.2174/1871520617666170213130523

Cited by 15 publications

(6 citation statements)

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“…Ingenol mebutate gel is an approved treatment option for cancerization field and non-hyperkeratotic, non-hypertrophic AK 8 . Several studies have shown that this topical agent is effective and cost-saving, with an acceptable tolerability profile 9–15 .…”

Section: Introductionmentioning

confidence: 99%

Field cancerization therapy with ingenol mebutate contributes to restoring skin-metabolism to normal-state in patients with actinic keratosis: a metabolomic analysis

Righi

Tarentini

Mucci

et al. 2019

Sci Rep

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Actinic keratosis (AK) is a skin premalignant lesion, which progresses into squamous cell carcinoma (SCC) if left untreated. Ingenol mebutate gel is approved for local treatment of non-hyperkeratotic, non-hypertrophic AK; it also has the potential to act as a field cancerization therapy to prevent the progression of AK to SCC. To gain better insights into the mechanisms of ingenol mebutate beyond the mere clinical assessment, we investigated, for the first time, the metabolome of skin tissues from patients with AK, before and after ingenol mebutate treatment, with high-resolution magic angle spinning nuclear magnetic resonance spectroscopy. The metabolomic profiles were compared with those of tissues from healthy volunteers. Overall, we identified a number of metabolites, the homeostasis of which became altered during the process of tumorigenesis from healthy skin to AK, and was restored, at least partially, by ingenol mebutate therapy. These metabolites may help to attain a better understanding of keratinocyte metabolism and to unmask the metabolic pathways related to cell proliferation. These results provide helpful information to identify biomarkers with prognostic and therapeutic significance in AK, and suggest that field cancerization therapy with ingenol mebutate may contribute to restore skin metabolism to a normal state in patients with AK.

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Section: Introductionmentioning

confidence: 99%

Field cancerization therapy with ingenol mebutate contributes to restoring skin-metabolism to normal-state in patients with actinic keratosis: a metabolomic analysis

Righi

Tarentini

Mucci

et al. 2019

Sci Rep

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“…Although precancerous lesions of the area, such as actinic cheilitis, have been treated with various topical drugs, such as actixicam, ingenol mebutate, diclofenac, imiquimod, fluorouracil, and photodynamic therapy [18][19][20], the only other topical treatment proposed, also in combination with surgery for lip SCC, was photodynamic therapy. A Chinese group proposed this solution using topical photodynamic therapy after surgery to treat lip SCC in a case series of two patients, with no recurrence reported after two years of follow-up [21].…”

Section: Discussionmentioning

confidence: 99%

Topical 5% Imiquimod Sequential to Surgery for HPV-Related Squamous Cell Carcinoma of the Lip

Pentangelo¹,

Nisticò

Provenzano

et al. 2021

Medicina

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Background: Squamous cell carcinoma (SCC) is one of the most common neoplasms affecting the oral cavity and the face. Its more differentiated forms may be associated with human papilloma virus (HPV) infection. Case report: In this paper, we report the case of an 86-year-old patient with a well-differentiated SCC of the lower lip associated with HPV treated with surgery with a non-complete histological resolution. Imiquimod 5% cream was applied on the surgical scar once a day for two weeks and then once a week. Two years after SCC removal, no relapse has occurred. Conclusions: Topical imiquimod may be a safe and effective treatment after surgery in SCC of the oral area to reduce the risk of relapses.

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“…BD mainly affects the elderly and the usual treatment approach is to use non-invasive topical therapies and reserve other treatments for recurrent/refractory cases. Several recent case reports suggest that IM is a potentially effective and safe treatment option for BD, with a short treating course [7][8][9][10][11][12]. However, only one study evaluating the effectiveness of IM gel in the treatment of BD has been published until now [13].…”

Section: Discussionmentioning

confidence: 99%

“…Further investigation is required to overcome these limitations and to provide additional data for the management of BD with IM. So far, since experience of IM for BD has been limited to only one study and some case reports and small series [7][8][9][10][11][12][13], there is a need for larger studies and also greater uniformity in the methodologies used to evaluate its effectiveness. The number of patients being treated, dose regimen (with or without occlusion during treatment), time of post-treatment assessment, methods for the evaluation of skin lesions, and the pretreatments performed should be considered.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study

Salleras¹

2019

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Management of BD is widely variable and there is little evidence for the most appropriate treatment. Our aim was to evaluate the effectiveness of ingenol mebutate (IM) gel in the treatment of patients with Bowen's disease (BD). We performed a retrospective analysis of 24 cases of biopsy-confirmed BD treated with IM. Data retrieved from the patients' file included age, sex, anatomic sites, clinical images of lesions, histopathological data of skin biopsies, local skin reactions, clinical and histological response to treatment, alternative treatments tried and follow-up. The majority of patients were females (18/24, 75%), with an average age of 79.5 years (range 53-90 years). Four of the 24 patients were lost to follow-up. The average duration of follow-up was 10.4 months (range 0.5-44 months). After treatment with IM, 41.7% of patients showed complete clinical resolution. Retreatment with IM of six non-responder patients led to three more cases of successful healing. Therefore, 54.2% of patients with BD lesions achieved complete resolution after treatment with one or two cycles of IM. Local skin reactions were mostly mild or moderate, and only 12.5% were regarded as severe. The results indicate that topical IM gel may be considered as a safe and beneficial non-invasive treatment option for BD, especially in patients who are poor candidates for surgery and anatomical sites that are unsuitable for other treatments. The acceptable safety profile, short treating course and easy self-application of IM gel may improve patient compliance.

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Topical Ingenol Mebutate: A New Treatment Modality for Multiple Actinic Keratoses and Field Cancerization

Cited by 15 publications

References 0 publications

Field cancerization therapy with ingenol mebutate contributes to restoring skin-metabolism to normal-state in patients with actinic keratosis: a metabolomic analysis

Field cancerization therapy with ingenol mebutate contributes to restoring skin-metabolism to normal-state in patients with actinic keratosis: a metabolomic analysis

Topical 5% Imiquimod Sequential to Surgery for HPV-Related Squamous Cell Carcinoma of the Lip

Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study

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