Photodynamic Therapy of Multiple Nonmelanoma Skin Cancers with Verteporfin and Red Light-Emitting Diodes Two-Year Results Evaluating Tumor Response and Cosmetic Outcomes

Harvey Lui, Lori Hobbs, Whitney D. Tope, Peter K. Lee, Craig Elmets, Nathalie Provost, Agnes Chan, Herma Neyndorff, Xiang Yao Su, Hem Jain, Iltefat Hamzavi, David McLean, Robert Bissonnette

Research output: Contribution to journalArticlepeer-review

90 Scopus citations

Abstract

Background: Efficient treatment of patients with multiple synchronous nonmelanoma skin cancers represents a therapeutic challenge. Objective: To study the safety and efficacy of photodynamic therapy (PDT) with verteporfin and red light in the treatment of multiple nonmelanoma skin cancers. Design: Open-label, randomized, multicenter, dose-ranging phase 2 study conducted at 4 North American university-based dermatology clinics. Patients: Fifty-four patients with 421 multiple nonmelanoma skin cancers including superficial and nodular basal cell carcinoma and squamous cell carcinoma in situ (Bowen disease). Methods: A single intravenous infusion of 14 mg/m2 of verteporfin followed 1 to 3 hours later by exposure of tumors to 60, 120, or 180 J/cm2 of red light (688 ± 10 nm) from a light-emitting diode panel. Main Outcome Measures: Pathologic response of treated sites was assessed at 6 months. Clinical and cosmetic responses were assessed and graded at 6 weeks, 3 months, and 6 months after verteporfin PDT, with optional follow-up visits at 12, 18, and 24 months. Results: The histopathologic response, defined as absence of tumor on biopsy specimens 6 months after verteporfin PDT, ranged from 69% at 60 J/cm2 to 93% at 180 J/cm 2. At 24 months of follow-up (276 tumors in 31 patients), the clinical complete response rate ranged from 51% at 60 J/cm2 to 95% at 180 J/cm2. No significant systemic adverse events were observed; most events occurred at the treated tumor sites and included events such as pain. Overall, 65% (95% confidence interval, 58%-71%) of tumors were judged to have good to excellent cosmesis at 24 months. Conclusion: A single course of verteporfin PDT showed treatment benefit for patients with multiple nonmelanoma skin cancers.

Original languageEnglish (US)
Pages (from-to)26-32
Number of pages7
JournalArchives of Dermatology
Volume140
Issue number1
DOIs
StatePublished - Jan 2004

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