Chemotherapy and Molecular Therapy in Non-Melanoma Skin Cancer

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the commonest skin malignancies and if diagnosed early have a good prognosis. Conversely, metastatic disease is rarely associated with a very poor prognosis. Locally advanced BCC is also uncommon and may not be amendable to surgery, radiation therapy or photodynamic therapy. The activation of the hedgehog pathway occurs in 90% of BCCs and inhibition of this pathway with well tolerated oral agents has resulted in an important therapeutic option in some patients with locally advanced or metastatic BCC. In contrast, metastatic SCC tends to behave biologically more aggressively and cisplatin based chemotherapy has very limited efficacy.