Clinical Medicine Reviews in Oncology

Imiquimod 5% cream (Aldara) was approved by the Food and Drug Administration for the treatment of non-facial superficial basal cell carcinomas (sBCC) in 2004 and has become one of the most commonly used topical treatments for this variant of basal cell carcinoma. Application of the cream once a day, 5 days per week for 6 weeks has demonstrated a clinical and histological cure rate approximating 80% for non-facial sBCCs. Erythema, erosions, and crusting are common local adverse events; but systemic side effects are much less common. The clinical use of imiqimod for nodular or facial basal cell carcinomas, particularly on the nose, has not been as successful. Cure rates range from 42%–76%, depending on the frequency and duration of use. Several reports have described the usefulness of imiquimod cream as an adjunctive therapy of basal cell carcinomas when combined with a surgical modality. However, most of these “adjunctive” studies were neither blinded nor controlled. We review the safety and efficacy of imiquimod 5% cream in the treatment of sBCC, report on its effectiveness in the treatment of nodular and facial basal cell carcinomas, and comment on its role as an adjunctive therapy.