James M. Kilgour, M.D., from Stanford University in Redwood City, California, and colleagues conducted a phase II, open-label trial of a topical HDAC inhibitor in participants with at least one BCC. One percent remetinostat gel was applied three times daily for six weeks; tumor diameter was measured at baseline and week 8. At the end of the study, surgical excision of the remaining tumor was performed and microscopic evaluation was conducted.

The analysis included 33 per-protocol tumors from 25 participants. The researchers found that the overall response rate, which was defined as the proportion of tumors achieving more than a 30 percent decrease in the longest diameter from baseline to week 8, was 69.7 percent. Overall, 54.8 percent of the tumors demonstrated complete resolution on pathologic examination. Similar levels of acetylated histone H3 were demonstrated in pharmacodynamic analysis of skin tissue before and after treatment, while there was an increase in phosphorylation. There were no reports of systemic adverse events.

"Given the tolerability and clinical and pathologic response rates demonstrated in this trial across several histological subtypes, HDAC inhibitors could be a realistic new class of topical agents for BCC," the authors write.

Several authors disclosed financial ties to Medivir, which provided the investigational product and supported the study.

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