A pilot study of clinical efficacy of imiquimod and cryotherapy for the treatment of basal cell carcinoma with incomplete response to imiquimod.

Background: Cryotherapy is a physical procedure whose immunogenic capability enables it to destroy tumour cells, at least partially. Consequently, it can boost the effect of imiquimod.
Objective: The objective of the present study was to evaluate the efficacy of combining cryotherapy and imiquimod in patients who did not achieve a complete response after treatment of basal cell carcinoma with imiquimod. The study sample comprised 22 patients with 23 basal cell carcinomas. The tumours were treated with liquid nitrogen (one cycle, 20-30 s) before application of imiquimod (five times weekly for 6 weeks).
Results: A maintained complete clinical response was observed in 19 of the 23 tumours (83%), a partial response in three and no response in one. One tumour presented signs of persistence/recurrence during follow-up.
Conclusions: Cryotherapy applied to treat imiquimod-refractory basal cell carcinoma seems to sensitize the tumour to the effect of the drug, thus reducing the percentage of patients who need surgery after an incomplete response to imiquimod. Further studies are necessary to confirm these findings.
(© 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.)