Randomized Pilot Study of Treatment for BCC Using the Multiplex 595/1064 nm Laser

Basal cell carcinoma is a malignancy with significant prevalence that rarely metastasizes but can be locally destructive. Laser therapy for this type of lesion may be a superior option for patients who do not wish to or cannot tolerate other modalities such as topical chemotherapeutics or surgery. In this pilot study, we will preliminarily assess the efficacy and safety of the 595/1064 nm Multiplex laser when treating superficial and nodular basal cell carcinomas less than 1.5 cm in size. Eligible patients with biopsy-proven superficial or nodular BCCs less than 1.5 cm in size will have the opportunity to enroll in this study. This is an unblinded study in which patients will be randomized to either a treatment arm or a control arm. Patients in the treatment arm will receive three treatments with the 595/1064 nm multiplex laser spaced four weeks apart. In addition to assessing the presence of any adverse effects, photographs will be taken at each visit. One month after the last treatment session, patients in this group will return for evaluation of 1) clinical clearance and 2) histological clearance of their BCC. In order to assess clinical clearance, a dermatologist will grossly examine, measure, and document any residual lesion. Afterwards, a deep excisional biopsy encompassing the entire region will be taken and histological clearance will be determined by a microscopic examination for any residual tumor cells. Follow-up for wound care of the biopsy will occur one week later. Tumor burden will be calculated by change in surface area of the lesion. After standard diagnostic biopsy, patients in the control arm will be followed for three regular visits, spaced 4 weeks apart. One month after the third follow-up visit, control patients will return for final photography and evaluation of clinical and histological clearance, just as the treatment arm. Although extremely rare1, if any clinical signs of progression are visible during this period (what we will consider greater than 10% growth), the patient will be withdrawn from the study and will undergo standard of care treatment.