Efficacy of Topical 5% Imiquimod Cream for the Treatment of Nodular Basal Cell Carcinoma

An Overview on Basal Cell Carcinoma

“…The data suggested that as the severity of these three local skin reactions increased, there was a greater trend in histologic clearance of sBCC (48). In addition to sBCC, imiquimod also has demonstrated efficacy in the treatment of nBCC.50,56 (90,91) Treatment with imiquimod once daily, seven times per week, for either 6 or 12 weeks resulted in nBCC histologic clearance rates of 71% to 76% (90). Because imiquimod promotes an inflammatory reaction to treat the tumor, treatment is generally associated with mild to-moderate local skin reactions, with severity related to frequency of application (92,93).…”

Guidelines of care for the management of basal cell carcinoma

“…Various regimens of imiquimod have been used in practice, including application twice daily, once daily, and every other day; applications have been performed with and without occlusion for treatment courses ranging from 6 to 16 weeks. 45,[64][65][66][67][68][69][70][71][72][73] Overall, rates of 3-to 12-month clinical and histologic cure have been reported to range from 60% to 80% in well-designed RCTs, with the highest rates reported for shorter follow-up and clinical J AM ACAD DERMATOL VOLUME jj, NUMBER j cure. Moderate-to-severe local treatment-associated adverse events include skin redness, swelling, erosions, crusts, vesicles, itching, and, occasionally, tingling sensations.…”

Basal Cell Carcinoma

“…In both studies histological examination of lesion site on 6-weeks post-treatment showed the highest clearance rate in the once daily for 7 days per week groups, with 71% of patients in the 6-week study and 76% of patients in the 12-week study having complete response following treatment. The authors pointed out that these response rates were lower than the nearly 88% response rates seen in studies of superficial BCC lesions (Shumack et al, 2002).This type of treatment modality applies better for those patients in which surgery, radiotherapy, or cryotherapy are not an option. The side effects from use of imiquimod are mainly local site reactions.…”

“…These histologic clearance rates for imiquimod were similar to those reported in the 6-week study (Marks et al, 2001), suggesting that an additional 6 weeks of treatment may not be necessary for efficacy. In addition to sBCC, imiquimod also has been demonstrated efficient in the treatment of nBCC (Shumack et al, 2002). One such study was a Phase II clinical trial comparing efficacy of various dosing regimens in a 6-week study in Australia and New Zealand and a 12-week study in United States.…”