Itraconazol gel en BCC

Topical Itraconazole for the Treatment of Basal Cell Nevus Syndrome or High-Frequency Basal Cell Carcinomas

• This study included 6 patients with basal cell nevus syndrome (81 tumors) and 3 patients with high-frequency basal cell carcinomas (BCC, 33 tumors) and found that itraconazole 0.7% gel twice daily for 4 to 12 weeks was not statistically more effective than placebo in shrinking tumor size in BCC.

• Itraconazole 0.7% gel was found to be safe, but it did not reduce GLI1 mRNA levels or tumor area. Given the promising results of topical and oral itraconazole in treatment of BCC in mice, further investigation is needed to determine if itraconazole at higher concentrations or in different formulations may be effective for human use.

– Caroline Crabtree, MD

abstract

Nonsurgical therapies are needed for patients with multiple basal cell carcinomas (BCCs). Vismodegib reduces BCCs but causes severe adverse effects and cannot be formulated as a topical treatment. Oral itraconazole is a weaker hedgehog (HH) pathway inhibitor and has shown evidence of reduced BCCs in Ptch1+/− mice and in 1 phase 2 trial. However, the risks of long-term treatment with oral itraconazole include liver dysfunction and congestive heart failure. We developed a topical itraconazole gel at the maximum soluble concentration that showed high dermal concentrations. In mice, itraconazole, 0.7%, gel reduced BCCs, showed no skin irritation, and achieved less than 1/100th the plasma level compared with oral itraconazole. Thus, we initiated a phase 2 trial evaluating itraconazole, 0.7%, gel vs placebo gel in patients with multiple BCCs.

JAMA Dermatology

Topical Itraconazole for the Treatment of Basal Cell Carcinoma in Patients With Basal Cell Nevus Syndrome or High-Frequency Basal Cell Carcinomas: A Phase 2, Open-Label, Placebo-Controlled Trial

JAMA Dermatol 2019 Jul 24;[EPub Ahead of Print], GK Sohn, GP Kwon, I Bailey-Healy, A Mirza, K Sarin, A Oro, JY Tang 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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