Chemotherapeutic Agents Promising for Treating Actinic Keratosis

Chemotherapeutics show potential in addressing actinic keratosis.

Patients with actinic keratosis (AK) treated with chemotherapeutic agents experienced a partial or complete inflammation regression rate of 96.4%, with taxanes, pemetrexed, and doxorubicin showing the most effectiveness, according to data from a systematic review and meta-analysis published in the Journal of Dermatological Treatment.

Investigators conducted a systematic review for articles written in English that presented data on patients with AK inflammation following chemotherapy. Investigators used Fisher’s Exact test to compare categorical variables and Kruskal Wallis test to compare the significance of association between categorical and numeric variables that were not normally distributed.

There were 28 articles that met the inclusion criteria, encompassing 36 patients with AK with a mean age of 68.4 years and a female-to-male ratio of 1:1. Prior to chemotherapy, 73.9% of patients had AK. The patients were exposed to 21 different chemotherapeutic agents, and 58.3% received monotherapy.

The overall median time from chemotherapy initiation to AK inflammation was 10 days and the median time to AK “cure” was 3 weeks, which were not significantly different between medication subgroups.

This high cure rate implies the opportunity for repositioning more drugs for the treatment of AK…

Inflamed AK partially regressed in 50% of patients and complete regression was seen in 46.4% of patients, respectively. The rate of AK resolution did not differ by chemotherapeutic subgroup, was not higher for patients treated with multidrug combinations compared with those on monotherapy, and 93.3% of those on multidrug therapy were treated with 1 of 5 chemotherapeutic agents linked to AK inflammation resolution as a monotherapy including 5-fluorouracil (5-FU), docetaxel, paclitaxel, pemetrexed, and doxorubicin. Outcomes of inflamed AK did not differ between patients in whom chemotherapy was adjusted compared with those in whom chemotherapy continued as intended.

The study was limited as data were combined across case reports and case series leading to low-quality evidence, and the differences in reporting inflamed AK outcomes among articles.

“This high cure rate [of 96.4%] implies the opportunity for repositioning more drugs for the treatment of AK, the development of which stems from simple but careful monitoring of the patients,” the study authors wrote, citing topical 5-FU as an example.

References:

Šuler Baglama Š, Peteln I, Jemec GBE. Inflamed actinic keratoses as a biomarker in repositioning of chemotherapeutics: a systematic review and meta-analysis. J Dermatolog Treat. Published online October 11, 2022. doi:10.1080/09546634.2022.2131298