Remetinostat to żel będący inhibitorem deacetylazy histonowej. W drugiej fazie badań klinicznych preparat wykazał oznaki skuteczności u pacjentów z rakiem podstawnokomórkowym (BCC). Zdaniem naukowców remetinostat może być bezpieczną alternatywą dla chirurgicznego leczenia nowotworu.
Remetinostat to pierwszy w swojej klasie inhibitor deacetylazy histonowej (HDAC) przeznaczony do stosowania miejscowego. Zespół badaczy kierowany przez Kavitę Sarin z Uniwersytetu Stanforda zidentyfikował zdolność hamowania HDAC jako obiecującą formę terapii raka podstawnokomórkowego.
Skuteczność preparatu zbadano łącznie na 49 guzach
Badania kliniczne drugiej fazy przeprowadzono wśród 30 dorosłych pacjentów, u których zidentyfikowano co najmniej jeden guz nowotworowy o średnicy 5 mm lub większej. Remetinostat został przetestowany łącznie na 49 guzach, które znajdowały się w różnych częściach ciała pacjentów (zarówno w miejscach wystawionych na działanie słoneczne, jak i nienaświetlanych).
Uczestnicy badania nakładli żel remetinostat na swoje guzy trzy razy dziennie przez sześć tygodni. Po ośmiu tygodniach, pozostałości guza usunięto chirurgicznie i zbadano histopatologicznie.
Większość zmian nowotworowych odpowiedziała na leczenie remetinostatem
33 zmiany nowotworowe w 69,7 proc. odpowiedziały na leczenie miejscowe, w tym 17 guzów odpowiedziało całkowicie, a 6 częściowo. Średnica guza zmniejszyła się średnio o 62,3 proc., a całkowita powierzchnia o 71,5 proc. Odpowiedź na leczenie zaobserwowano w wielu podtypach BCC: powierzchownej (5 odpowiedzi całkowitych, 1 częściowa), guzkowej (10 odpowiedzi całkowitych, 5 częściowych) oraz naciekających (2 pełne odpowiedzi). Jedynie wśród dwóch guzów podtypu mikroguzkowego nie zaobserwowano odpowiedzi na leczenie.
W trakcie badania nie zaobserwowano żadnych ogólnoustrojowych lub poważnych zdarzeń niepożądanych. Niektórzy pacjenci zgłaszali jedynie łagodne reakcje skórne w miejscu podania preparatu, podobne do egzemy.
Obiecujące wyniki badań
– Chociaż potrzebne są dalsze badania, nasze wyniki sugerują, że remetinostat może być bezpieczną i obiecującą alternatywą dla leczenia chirurgicznego raka podstawnokomórkowego ze względu na wysoki wskaźnik całkowitych odpowiedzi, który zaobserwowaliśmy – zaznacza Kavita Sarin.
Zdaniem eksperta, jeśli terapia ma zastąpić leczenie chirurgiczne, musi wywołać nie tylko pełną odpowiedź na leczenie, ale także trwałą. Dlatego kolejne badania nad remetinostatem będą skupiać się właśnie na tym aspekcie.
Czym jest rak podstawnokomórkowy?
BCC jest złośliwym nowotworem skóry wywodzącym się z nierogowaciejących komórek warstwy podstawnej naskórka. Czynnikami rozwoju raka podstawnokomrówkowego jest ekspozycja na promienie UV, immunosupresja, przewlekłe zakażenia np. wirusem brodawczaka czy HPV.
Zmiany pojawiają się najczęściej na odkrytych częściach ciała i rozwijają się głównie na skórze głowy i szyi (powieki, czoło, nos, policzki). Nieleczony nowotwór może przyczyniać się do powolnego niszczenia coraz większego obszaru przyległej skóry oraz głębszej struktury ciała, np. chrząstki nosa czy kości czaszki. Zmiany mogą naciekać sąsiadujące elementy kostne, chrzęstne, naczyniowe, nerwowe lub gałkę oczną. Raka podstawnokomórkowego cechują niewielkie owrzodzenia z wałowatym brzegiem. Inną postacią nowotworu są guzki nietorbielowate.
Leczenie nowotworu odbywa się za pomocą radykalnego usunięcia zmiany wraz z marginesem zdrowych tkanek. W przypadkach, gdy zabieg chirurgiczny jest niemożliwy, w praktyce klinicznej wdraża się radioterapię, a w razie rzadkich przerzutów – chemioterapię.
Przeczytaj także: Powstał materiał opatrunkowy o właściwościach skóry
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