Novel Optical Technology May Improve Evaluation of Treatment Response of Basal Cell Carcinomas
Posted: Monday, November 8, 2021
A new noninvasive method of monitoring superficial basal cell carcinoma may help catch subclinical signs of disease that might go undetected by usual examination methods in patients treated with imiquimod 5% cream. Francesco Lacarrubba, MD, of the University of Catania, Italy, and colleagues described their experience with line-field confocal optical coherence tomography (OCT) in Cancers, calling the technology “a sort of ‘virtual biopsy’ [allowing] the visualization of the epidermis and dermis and their different structures and findings at the cellular level.”
In this pilot study, the investigators monitored 12 patients with a total of 20 superficial basal cell carcinomas that were treated with the immune response modifier imiquimod 5% cream, once daily, 5 days a week, for 6 weeks. Four weeks after the last treatment, 3 of the 20 lesions showed a complete clinical response via standard inspection techniques, but line-field OCT revealed residual tumoral signs at a microscopic level. (A total of 13 lesions showed complete clinical and line-field OCT responses, whereas 4 lesions demonstrated partial clinical and line-field OCT responses.)
According to the investigators, this tool offered “a detailed, fast, and complete examination of the treated area, [finding] three cases of residual basal cell carcinoma that otherwise would have gone undetected.” The seven lesions that showed persistence of basal cell carcinoma with any level of clinical and/or line-field OCT evidence were further treated by surgical excision or another cycle of imiquimod 5% cream.
Dr. Lacarrubba and colleagues described the current challenge in following up basal cell carcinoma that has been treated nonsurgically. Clinical inspection, they wrote, “cannot exclude the persistence of subclinical disease responsible for relapses. On the other hand, post-treatment biopsies for histopathology confirmation of resolution are rarely performed, as they only analyze partial samples. Additionally, multiple biopsies impair the advantages of a lack of invasiveness and good aesthetic results due to the use of noninvasive treatments.”
Disclosure: The study authors reported no conflicts of interest.
