Photodynamic therapy with a 5-ALA patch does not increase the risk of conversion of actinic keratoses into squamous cell carcinoma: Results of a multicentre non-interventional study

Exp Dermatol. 2018 Dec;27(12):1399-1402. doi: 10.1111/exd.13804.

Abstract

Background: It is important to collect data about the risk of transformation of an actinic keratosis (AK) lesion into squamous cell carcinoma (SCC) after a single photodynamic therapy (PDT) with 5-ALA patch for a longer follow-up period under daily routine.

Questions addressed: The purpose of this non-interventional study (NIS) was to collect data on the frequency of occurrence of SCCs in the treated area during an interval of 2 years after a single 5-ALA patch-PDT.

Experimental design: This prospective observational case-only study included patients with mild AK lesions on the head and face treated with 5-ALA patch-PDT according to the Summary of Product Characteristics (SPC).

Results: In 370 patients, the risk of transformation of their treated AK lesion into SCC was 0.073% with its exact 95% confidence interval using the Poisson distribution of [0.009%, 0.262%]. The rate of complete clinical clearance on lesion basis after 3 months was 84.3%.

Conclusion: The efficacy and the safety results show no observation of an increased risk for conversion of an AK into a SCC 2 years after a single 5-ALA patch-PDT. Additionally, the high clinical complete remission rate under routine conditions is comparable to the rates observed in the approval trials.

Keywords: 5-Aminolevulinic Acid; Alacare,®; Effala,®; non-melanoma skin cancer; observational study; risk of transformation.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aminolevulinic Acid / administration & dosage*
  • Aminolevulinic Acid / adverse effects
  • Carcinoma, Squamous Cell / prevention & control*
  • DNA Damage
  • Disease Progression
  • Humans
  • Keratosis, Actinic / drug therapy*
  • Oxidative Stress
  • Photochemotherapy* / adverse effects
  • Precancerous Conditions / drug therapy
  • Prospective Studies
  • Risk

Substances

  • Aminolevulinic Acid