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Current Cancer Therapy Reviews

Editor-in-Chief

ISSN (Print): 1573-3947
ISSN (Online): 1875-6301

Novel Strategies for Effective Actinic Keratosis Treatment: A Review

Author(s): Sudhir Kumar, Rakesh Kumar, Bikash Medhi and Vivek R. Sinha

Volume 11, Issue 2, 2015

Page: [119 - 132] Pages: 14

DOI: 10.2174/1573394711666150825213929

Price: $65

Abstract

Actinic keratoses (AKs) are common premalignant skin lesions. These are epidermal neoplasms of altered keratinocytes. Development of Actinic keratosis is correlated with chronic exposure of UVB sun radiation resulting in formation of cyclobutane pyrimidine dimmers (CPDs). During UV exposure, expression of tumor suppressor gene p53 is enhanced, which protects and repairs damaged DNA, failing which, cell leads to apoptosis. An irreversible damage to p53 gene results in failure of apoptosis and DNA repair resulting in expansion of cells into neoplasm. Risk of progression of these actinic keratosis lesions to squamous cell carcinoma makes it necessary to treat them aggressively. Various modalities like, lesion directed therapy (cryosurgery, curettage and electrodessication) and field directed therapy (5-fluorouracil, diclofenac, imiquimod, photodynamic therapy etc) exists for its treatment. US Food and Drug Administration has approved 5 medications for AK treatment which are topical 5-Fluorouracil, imiquimod cream, diclofenac gel, ingenol mebutate gel and photodynamic therapy. To enhance the outcome of available treatment strategies, their combination are gaining popularity and interests of dermatologists because of their efficacy and tolerability. Fluorouracil and salicylic acid Actikerall® combination is such an example which has received marketing approval from Medicines and Healthcare Products Regulatory Agency in UK for AK treatment. This combination therapy approach is supposed to be another step towards the ultimate goal of enhancing the effectiveness of skin cancer treatments and reducing the number of surgical excisions performed on the millions of people with these precancerous skin lesions.

Keywords: 5-FU, actinic keratosis, chemptherapy, combination therapy, economic considerations, squamous cell.


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