Jet-injected photodynamic therapy with ALA well tolerated in basal cell carcinoma
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Key takeaways:
- PDT with ALA works well in BCC treatment, but is limited by injection depth.
- Jet-injected PDT could be a viable option if it is efficacious and tolerable.
SAN DIEGO — Basal cell carcinoma treatment with jet injection of photodynamic therapy was well tolerated by patients in a pilot study, according to a poster presentation at the American Academy of Dermatology Annual Meeting.
“Photodynamic therapy (PFT) with topical [delta]-amino-levulinic acid (ALA) has efficacy in treating [basal cell carcinoma (BCC)],” Leore Lavin, MS, of Memorial Sloan Kettering Cancer Center, and colleagues wrote.
Limitations exist for this due to inability of ALA to enter into deeper dermis; however, jet-injection allows for further penetration, according to the authors.
This open-label, prospective pilot study enrolled 15 adult patients with at least one low-risk nodular or mixed superficial and nodular BCC.
In group one, 11 subjects received two sessions of jet-injected ALA (20% solution) with PDT at intervals of 4 to 6 weeks. In group two, four patients received one session of jet-injected ALA followed by tumor excision and fluorescence microscopy.
Longitudinal local skin response (LSR) scores, including erythema, edema, flaking, crusting, pustulation and erosion/ulceration scored 0 to 4, were evaluated at six visits over 3 months.
At the first follow-up visit the mean composite LSR score was 5, which decreased to 0.5 at the last follow-up visit (P < .01).
The mean pain score was 5.6 during jet-injection and 3.7 during illumination.
Seventy percent of patients had local scarring, one patient had cellulitis and one patient had BCC tumor recurrence.
Using immunofluorescence, researchers found photosensitizer penetration of ALA into the papillary and reticular dermis.
Patient satisfaction was rated at 9.4 out of 10.
“The unique usage of jet injection for PDT treatment for BCC is safe and tolerable for patients and may represent a novel modality to improve PDT for deeper tumors,” the authors wrote in the poster’s abstract.
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Lavin L, et al. Jet-injection assisted photodynamic therapy for basal cell carcinoma. Presented at: American Academy of Dermatology Annual Meeting; March 8-13, 2024; San Diego.
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