Fractionated CO2 Laser-Assisted Delivery of Topical 5-Fluorouracil as a Useful Modality for Treating Field Cutaneous Squamous Cell Carcinomas

Glenn, Candace; Parlette, Eric C; Mitchell, Christina L.

doi:10.1097/dss.0000000000000473

Cited by 11 publications

(3 citation statements)

References 3 publications

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“…Further studies have demonstrated the risk of systemic absorption with other drugs following fractional ablative laser. One report described fever, malaise, and chills in a single patient after 5‐FU was applied under occlusion for 5 days following fractional CO 2 laser of both forearms . In contrast, Hsu and co‐workers reported no such side effects in 26 patients who underwent similar treatment.…”

Section: Introductionmentioning

confidence: 99%

Challenges to laser‐assisted drug delivery: Applying theory to clinical practice

et al. 2017

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Background The percutaneous penetration of topically applied compounds can be enhanced using external chemical or physical sources and thus laser‐assisted drug delivery is a burgeoning area of interest within the field of dermatology. Objectives This article briefly discusses the mechanism of laser‐assisted drug delivery and expands upon the challenges and safety issues that may arise in the clinical implementation of this modality. Results The existing literature demonstrates that investigators and clinicians in dermatology have successfully delivered anti‐inflammatory, anti‐neoplastic, and anti‐oxidative medications transdermally for the treatment of a variety of conditions including scarring, photoageing, and cutaneous neoplasia. Despite growth of the field, much remains to be learned about the applicability of laser‐assisted drug delivery in humans, and practitioners are faced with new safety concerns that may be associated with this treatment modality. Conclusions Challenges in laser assisted drug delivery include unpredictability of dosing and response to therapy, possibility of inducing local and systemic reactions, and variability in treatment regimens. Lasers Surg. Med. 50:20–27, 2018. © 2017 Wiley Periodicals, Inc.

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Section: Introductionmentioning

confidence: 99%

Challenges to laser‐assisted drug delivery: Applying theory to clinical practice

et al. 2017

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“…Various studies proposed a combination of fractional carbon dioxide laser and 5% 5-fluorouracil under occlusion to enhance drug penetration, with a substantial reduction of the tumor mass [ 30 ]. Nguyen et al proposed the treatment of superficial BCC and SCC with combination therapy of ablative fractional carbon dioxide laser and the subsequent topical application of 5% 5-fluorouracil under occlusion for 7 days, exploiting the cutaneous pores generated by the laser to enhance drug penetration in the skin [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

Bennardo

Giudice

et al. 2021

Current Oncology

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Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition’s gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient’s ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.

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“…5-FU was proved to be efficient for treating psoriasis, vitiligo, actinic keratosis, and skin tumors 21 . The CO 2 laser-assisted 5-FU delivery is evaluated in clinical trials for skin-cancer management 22, 23, 24. Since the topical drug therapy is always applied on the barrier-defective diseased skin, we first prepared the impaired skin according to the standardized methods for examining permeation.…”

Section: Discussionmentioning

confidence: 99%

Fractional Laser-Mediated siRNA Delivery for Mitigating Psoriasis-like Lesions via IL-6 Silencing

Lee

Lin

Alalaiwe

et al. 2020

Molecular Therapy - Nucleic Acids

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The poor permeability of topically applied macromolecules such as small interfering RNA (siRNA) has inhibited the translation to clinical application. In this study, the fractional CO2 laser-assisted approach was developed to describe siRNA permeation enhancement mediated by the created microchannels for silencing the gene to treat psoriasiform lesions. In vitro permeation using Franz cell and in vivo interleukin (IL)-6 silencing using psoriasis-like plaque in mice were evaluated to verify the impact of the laser irradiation. Low-fluence laser exposure enabled a significant increase in skin transport of siRNA, peptide, and 5-fluorouracil (5-FU). The laser treatment resulted in the enhancement of siRNA flux by 33- and 14-fold as compared to the control in nude mouse and pig skin, respectively. The laser exposure also promoted siRNA penetration across psoriatic and photoaging skins with the deficient barrier, although the enhancement level was minor compared to that of intact skin. The 3D images of confocal microscopy revealed a diffusion of macromolecules into the laser-created microchannels; the radial and vertical distribution to the surrounding and deep tissues followed this. A single laser treatment and the following topical siRNA administration were able to reduce IL-6 expression by 64% in the psoriatic skin model. Laser assistance led to the marked improvement in the plaque and the reduction of specific cytokine expression, keratinocyte proliferation, and neutrophil infiltration. Our data support the use of the fractional laser for delivery of functional nucleic acid into the skin and the target cells.

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Fractionated CO2 Laser-Assisted Delivery of Topical 5-Fluorouracil as a Useful Modality for Treating Field Cutaneous Squamous Cell Carcinomas

Cited by 11 publications

References 3 publications

Challenges to laser‐assisted drug delivery: Applying theory to clinical practice

Challenges to laser‐assisted drug delivery: Applying theory to clinical practice

Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

Fractional Laser-Mediated siRNA Delivery for Mitigating Psoriasis-like Lesions via IL-6 Silencing

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