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29 maart 2019: JCI Insight maart 2019

Wanneer mensen 4 dagen een zalf smeren met calcipotriol plus 5-fluorouracil (5-FU) op hun gezicht en hoofd dan blijkt deze zalf AK =  actinische keratosis te voorkomen. Na 3 jaar had maar 7 procent van de deelnemers die de zalf hadden gebruikt nieuwe plekken van actinische keratosis (AK) tegenover 28 procent van de mensen die een zalf met vaseline plus 5-FU hadden gehad. 

Een actinische keratose is een beschadiging van de huid door zonlicht. Het zijn meestal kleine, iets verdikte plekjes van de huid, die ruw aanvoelen. Deze keratose-plekjes ontstaan op delen van je lichaam die vaak in de zon zijn geweest, zoals je gezicht of de bovenkant van je handen.

De studie werd uitgevoerd in Sydney - Australië waar actinische keratose veel voorkomt door de sterke zon.

Hier een grafiek welke mensen binnen 1, 2 en 3 jaar een AK of huidkanker kregen:

Cancer outcomes on treated face and scalp

Cancer outcomes on treated face and scalp

Het volledige studierapport: Skin cancer precursor immunotherapy for squamous cell carcinoma prevention is gratis in te zien.

Hier het abstract van de studie:

Skin cancer precursor immunotherapy for squamous cell carcinoma prevention

First published March 21, 2019 -

Abstract

BACKGROUND. Topical calcipotriol plus 5-fluorouracil (5-FU) combination is an effective immunotherapy against actinic keratosis (AK), which is a precursor to squamous cell carcinoma (SCC). However, the long-term effectiveness of calcipotriol plus 5-FU treatment for SCC prevention is unknown.

METHODS. We performed a blinded prospective cohort study on participants of a randomized double-blind clinical trial in which a 4-day course of topical calcipotriol plus 5-FU combination was compared to Vaseline plus 5-FU (control) for AK treatment. SCC and basal cell carcinoma (BCC) incidences were assessed at 1, 2, and 3 years after trial. Tissues were analyzed for calcipotriol plus 5-FU–induced T cell immunity in the skin.

RESULTS. Calcipotriol plus 5-FU–induced tissue-resident memory T (Trm) cell formation in face and scalp skin associated with significantly higher erythema scores compared with control (P < 0.01). Importantly, more participants in the test cohort remained SCC-free over the more than 1,500-day follow-up period (P = 0.0765), and significantly fewer developed SCC on the treated face and scalp within 3 years (2 of 30 [7%] versus 11 of 40 [28%] in control group, hazard ratio 0.215 [95% CI: 0.048–0.972], P = 0.032). Accordingly, significantly more epidermal Trm cells persisted in the calcipotriol plus 5-FU–treated face and scalp skin compared with control (P = 0.0028). There was no significant difference in BCC incidence between the treatment groups.

CONCLUSION. A short course of calcipotriol plus 5-FU treatment on the face and scalp is associated with induction of robust T cell immunity and Trm formation against AKs and significantly lowers the risk of SCC development within 3 years of treatment.

FUNDING. This research was supported by internal academic funds and by grants from the Burroughs Wellcome Fund, Sidney Kimmel Foundation, Cancer Research Institute, and NIH.

Author contributions

LAC and SD conceived and designed the clinical study. ARR, MT, and KHN performed the clinical study and related data collection. ARR, LAC, and SD interpreted the data and wrote the manuscript. ISR contributed to clinical data. MW performed the statistical analysis.

Supplemental material

View Supplemental data

View ICMJE disclosure forms

Acknowledgments

We thank Barbara Gilchrest, David Fisher, Keith Flaherty, and Ethan Lerner for critically reading the manuscript. Shadmehr Demehri holds a Career Award for Medical Scientists award from the Burroughs Wellcome Fund. KHN and SD were supported by grants from the Burroughs Wellcome Fund, Sidney Kimmel Foundation, Cancer Research Institute and NIH (K08AR068619 and DP5OD021353).

Footnotes

Conflict of interest: LAC and SD are co-inventors on a filed patent for the use of calcipotriol plus 5-fluorouracil for the treatment of precancerous skin lesions (PCT/US2015/049434).

License: Copyright 2019, American Society for Clinical Investigation.

Reference information: JCI Insight. 2019;4(6):e125476. https://doi.org/10.1172/jci.insight.125476.

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Version history
  • Version 1 (March 21, 2019): Electronic publication

 

actinische keratose, Calcipotriol met 5-fluorouracil (5-FU), huidkanker type plaveisel carcinoom, preventie, immuuntherapeutisch effect


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