JAMA Dermatol

Imiquimod plus superficial curettage less effective than surgery for nodular BCC

February 10, 2025

It couldn't be concluded that superficial curettage (SC) followed by imiquimod is noninferior to surgical excision (SE) for nodular basal cell carcinoma (nBCC), with a higher rate of treatment failure observed at 5 years in the SC plus imiquimod group. Most treatment failures occurred in the first year after treatment. However, authors point out that the probability of 5-year tumor-free survival rate after treatment with SC plus imiquimod was still 77.8%. The findings may be useful when counseling patients on the relative benefits and trade-offs of the different treatment options for nBCC.

Study details: This secondary analysis of the SCIN randomized trial compared the efficacy of SC followed by imiquimod 5% cream vs. SE in treating nBCC. The study included 145 patients with primary nBCC, randomized to either SC plus imiquimod (n=73) or SE (n=72), with a follow-up period of 5 years.

Results: The 5-year probability of remaining free from treatment failure was 77.8% in the SC plus imiquimod group vs. 98.2% in the SE group. The relative risk of treatment failure was 15.93 (95% confidence interval, 2.10-120.64), which did not exclude the prespecified noninferiority relative risk margin of 5.22.

Source:

Verkouteren BJA, et al. (2025, January 29). JAMA Dermatol. Imiquimod Cream Preceded by Superficial Curettage vs Surgical Excision for Nodular Basal Cell Carcinoma: A Secondary Analysis of a Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39878970/