2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T4bb,Participants were selected by consecutive sampling of 163 screened patients following exclusion of 93 individuals due to ineligibility or patients opting out. Among 70 enrolled participants (median [IQR] age, 75.50 [69.00-79.00] years; 47 [67%] male), 69 completed the study. Median (IQR) AK reductions were higher in the HPV-vaccinated vs sham group, shown consistently over the study period (month 2: 35% [25%-44%] vs 25% [18%-33%]; P = .03; month 6: 47% [33%-53%] vs 29% [16%-44%]; P = .01; month 9: 58% [37%-63%] vs 42% [33%-56%]; P = .09; month 12: 58% [47%-69%] vs 47% [32%-65%]; P = .05). Total AK numbers were correspondingly lower in the HPV-vaccinated group (median [IQR] at month 6: 14.00 [11.00-16.00] vs 17.00 [12.00-23.00]; P = .01; month 12: 10.00 [6.00-24.00] vs 16.00 [8.50-21.00]; P = .02). Coincidingly, fewer thick AKs were observed in the HPV-vaccinated group (median [IQR] at month 6: 5.00 [3.00-7.00] vs 6.50 [3.75-10.00]; P = .02; month 12: 3.00 [2.00-5.00] vs 5.00 [2.50-8.50]; P = .049). In contrast, no significant differences in rates of new AKs (1-2 AK[s] per month) or KC numbers overall or per participant were identified during the 12-month trial.31:Tba5,The substantial morbidity and socioeconomic costs associated with actinic keratosis (AK) management represent major public health concerns. Anecdotal evidence suggests that human papillomavirus (HPV) vaccination may offer therapeutic and preventive effects against AK and keratinocyte carcinomas (KCs). To investigate the effect of HPV vaccination on burden of disease in immunocompetent patients with high numbers of AK. The VAXAK trial was a parallel-design, double-blind, randomized sham-controlled clinical trial with 12 months' follow-up. This single-center trial was conducted at the Department of Dermatology, Bispebjerg University Hospital in Copenhagen, Denmark, between May 2021 and June 2024. Eligible participants were immunocompetent adults with 15 or more clinical AK lesions in a 50 cm2 to 100 cm2 test area on the head, trunk, or extremities. Participants were randomized 1:1 to blinded, 9-valent alphapapillomavirus vaccine or sham vaccine (isotonic sodium chloride solution), each administered intramuscularly at 0, 2, and 6 months. Thick AKs (Olsen grade II-III) received cryotherapy at months 6 and 9; test areas were otherwise untreated during the study. The preselected primary outcome was the percentage reduction in baseline AKs assessed 2, 6, 9, and 12 months after first vaccination. Secondary outcomes included total AK number, thick lesions, new AKs, and rate of incident KCs over 12 months. Participants were selected by consecutive sampling of 163 screened patients following exclusion of 93 individuals due to ineligibility or patients opting out. Among 70 enrolled participants (median [IQR] age, 75.50 [69.00-79.00] years; 47 [67%] male), 69 completed the study. Median (IQR) AK reductions were higher in the HPV-vaccinated vs sham group, shown consistently over the study period (month 2: 35% [25%-44%] vs 25% [18%-33%]; P = .03; month 6: 47% [33%-53%] vs 29% [16%-44%]; P = .01; month 9: 58% [37%-63%] vs 42% [33%-56%]; P = .09; month 12: 58% [47%-69%] vs 47% [32%-65%]; P = .05). Total AK numbers were correspondingly lower in the HPV-vaccinated group (median [IQR] at month 6: 14.00 [11.00-16.00] vs 17.00 [12.00-23.00]; P = .01; month 12: 10.00 [6.00-24.00] vs 16.00 [8.50-21.00]; P = .02). Coincidingly, fewer thick AKs were observed in the HPV-vaccinated group (median [IQR] at month 6: 5.00 [3.00-7.00] vs 6.50 [3.75-10.00]; P = .02; month 12: 3.00 [2.00-5.00] vs 5.00 [2.50-8.50]; P = .049). In contrast, no significant differences in rates of new AKs (1-2 AK[s] per month) or KC numbers overall or per participant were identified during the 12-month trial. In this randomized clinical trial, standard alphapapillomavirus vaccination was found to reduce AK burden in immunocompetent individuals with multiple lesions. HPV-targeted vaccines may be useful for management of AK, a chronic, relapsing disease and the most common precancer in fair-skinned populations. ClinicalTrials.gov Identifier: NCT05202860.32:Tfc2,ImportanceThe substantial morbidity and socioeconomic costs associated with actinic keratosis (AK) management represent major public health concerns. Anecdotal evidence suggests that human papillomavirus (HPV) vaccination may offer therapeutic and preventive effects against AK and keratinocyte carcinomas (KCs).ObjectiveTo investigate the effect of HPV vaccination on burden of disease in immunocompetent patients with high numbers of AK.Design, Setting, and ParticipantsThe VAXAK trial was a parallel-design, double-blind, randomized sham-controlled clinical trial with 12 months’ follow-up. This single-center trial was conducted at the Department of Dermatology, Bispebjerg University Hospital in Copenhagen, Denmark, between May 2021 and June 2024. Eligible participants were immunocompetent adults with 15 or more clinical AK lesions in a 50 cm2 to 100 cm2 test area on the head, trunk, or extremities.InterventionsParticipants were randomized 1:1 to blinded, 9-valent alphapapillomavirus vaccine or sham vaccine (isotonic sodium chloride solution), each administered intramuscularly at 0, 2, and 6 months. Thick AKs (Olsen grade II-III) received cryotherapy at months 6 and 9; test areas were otherwise untreated during the study.Main Outcomes and MeasuresThe preselected primary outcome was the percentage reduction in baseline AKs assessed 2, 6, 9, and 12 months after first vaccination. Secondary outcomes included total AK number, thick lesions, new AKs, and rate of incident KCs over 12 months.ResultsParticipants were selected by consecutive sampling of 163 screened patients following exclusion of 93 individuals due to ineligibility or patients opting out. Among 70 enrolled participants (median [IQR] age, 75.50 [69.00-79.00] years; 47 [67%] male), 69 completed the study. Median (IQR) AK reductions were higher in the HPV-vaccinated vs sham group, shown consistently over the study period (month 2: 35% [25%-44%] vs 25% [18%-33%]; P = .03; month 6: 47% [33%-53%] vs 29% [16%-44%]; P = .01; month 9: 58% [37%-63%] vs 42% [33%-56%]; P = .09; month 12: 58% [47%-69%] vs 47% [32%-65%]; P = .05). Total AK numbers were correspondingly lower in the HPV-vaccinated group (median [IQR] at month 6: 14.00 [11.00-16.00] vs 17.00 [12.00-23.00]; P = .01; month 12: 10.00 [6.00-24.00] vs 16.00 [8.50-21.00]; P = .02). Coincidingly, fewer thick AKs were observed in the HPV-vaccinated group (median [IQR] at month 6: 5.00 [3.00-7.00] vs 6.50 [3.75-10.00]; P = .02; month 12: 3.00 [2.00-5.00] vs 5.00 [2.50-8.50]; P = .049). In contrast, no significant differences in rates of new AKs (1-2 AK[s] per month) or KC numbers overall or per participant were identified during the 12-month trial.Conclusions and RelevanceIn this randomized clinical trial, standard alphapapillomavirus vaccination was found to reduce AK burden in immunocompetent individuals with multiple lesions. HPV-targeted vaccines may be useful for management of AK, a chronic, relapsing disease and the most common precancer in fair-skinned populations.Trial RegistrationClinicalTrials.gov Identifier: NCT0520286033:Ta70,Therapies for individual keratinocyte carcinomas (KCs) do not prevent the onset of new KCs in a field of sun damage, and therefore the KC burden remains unchanged. To investigate the association of immune checkpoint inhibitors (ICIs) with changes in field cancerization evaluated by the number of actinic keratoses (AKs) and KCs at baseline compared with 12 months after starting ICI therapy. This prospective cohort study was performed at the outpatient oncology clinic of a single tertiary public hospital in Brisbane, Australia, from April 1, 2022, to November 30, 2023. Consecutive immunocompetent adults starting therapy with an inhibitor for programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PDL-1) for any active cancer, with a planned treatment duration of at least 6 months, and who exhibited clinical AKs on their forearms were eligible. Those with immunosuppression, concurrent chemotherapy or radiotherapy, or recent topical fluorouracil use were excluded. Intravenous ICI therapy, either PD-1 or PDL-1 inhibitors with or without a cytotoxic T-lymphocyte-associated protein 4 inhibitor, with therapy duration determined by the treating oncologist. Clinical AKs were counted and photographed before and 3, 6, and 12 months after starting ICI therapy. KC numbers were evaluated based on histopathology reports of all skin lesions excised 12 months before and after starting ICI therapy. Participants' medical history, primary cancer tumor response using Response Evaluation Criteria in Solid Tumors, and adverse events were recorded. A total of 23 participants were recruited, of whom 17 (73.9%) were male, with a mean (SD) age of 69.7 (9.6) years. No participants withdrew; however, 4 died during the study due to disease progression. The mean (SD) AK number significantly decreased from 47.2 (33.8) at baseline to 14.3 (12.0) at 12 months (P < .001). Younger patients (8 of 12 [66.7%] vs 4 of 12 [33.3%]; P = .007) and those with a history of blistering sunburn (12 of 12 [100%] vs 0; P = .005) were more likely to reduce their AK numbers by 65% or greater. KC total numbers decreased from 42 in the 12 months before starting ICI therapy to 17 in the 12 months after. The number of cutaneous squamous cell carcinomas decreased from 16 to 5 in the same period. This pilot cohort study found that ICIs used for any cancer were associated with a significant reduction of AKs, suggesting potential as an immunopreventive strategy for high-risk individuals. Given the known effects of other chemopreventive agents on KCs, further investigation into ICIs managing field cancerization is required, especially considering toxicity and cost.34:Td87,ImportanceTherapies for individual keratinocyte carcinomas (KCs) do not prevent the onset of new KCs in a field of sun damage, and therefore the KC burden remains unchanged.ObjectiveTo investigate the association of immune checkpoint inhibitors (ICIs) with changes in field cancerization evaluated by the number of actinic keratoses (AKs) and KCs at baseline compared with 12 months after starting ICI therapy.Design, Setting, and ParticipantsThis prospective cohort study was performed at the outpatient oncology clinic of a single tertiary public hospital in Brisbane, Australia, from April 1, 2022, to November 30, 2023. Consecutive immunocompetent adults starting therapy with an inhibitor for programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PDL-1) for any active cancer, with a planned treatment duration of at least 6 months, and who exhibited clinical AKs on their forearms were eligible. Those with immunosuppression, concurrent chemotherapy or radiotherapy, or recent topical fluorouracil use were excluded.ExposuresIntravenous ICI therapy, either PD-1 or PDL-1 inhibitors with or without a cytotoxic T-lymphocyte–associated protein 4 inhibitor, with therapy duration determined by the treating oncologist.Main Outcomes and MeasuresClinical AKs were counted and photographed before and 3, 6, and 12 months after starting ICI therapy. KC numbers were evaluated based on histopathology reports of all skin lesions excised 12 months before and after starting ICI therapy. Participants’ medical history, primary cancer tumor response using Response Evaluation Criteria in Solid Tumors, and adverse events were recorded.ResultsA total of 23 participants were recruited, of whom 17 (73.9%) were male, with a mean (SD) age of 69.7 (9.6) years. No participants withdrew; however, 4 died during the study due to disease progression. The mean (SD) AK number significantly decreased from 47.2 (33.8) at baseline to 14.3 (12.0) at 12 months (P &lt; .001). Younger patients (8 of 12 [66.7%] vs 4 of 12 [33.3%]; P = .007) and those with a history of blistering sunburn (12 of 12 [100%] vs 0; P = .005) were more likely to reduce their AK numbers by 65% or greater. KC total numbers decreased from 42 in the 12 months before starting ICI therapy to 17 in the 12 months after. The number of cutaneous squamous cell carcinomas decreased from 16 to 5 in the same period.Conclusions and RelevanceThis pilot cohort study found that ICIs used for any cancer were associated with a significant reduction of AKs, suggesting potential as an immunopreventive strategy for high-risk individuals. Given the known effects of other chemopreventive agents on KCs, further investigation into ICIs managing field cancerization is required, especially considering toxicity and cost.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Keratinocyte Carcinoma: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Keratinocyte Carcinoma (condition). Clinician-written summaries and actionable practice insights. 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The non-VHA cost scenario partially addresses this but uses different cost assumptions.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.1639","tag_type":"warning","value":"The study design is observational (retrospective cohort), so nicotinamide exposure was not randomized; residual confounding cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This economic evaluation assessed the cost-effectiveness of oral nicotinamide vs. no nicotinamide for keratinocyte carcinoma (KC) prevention over a 1-year horizon in 33,822 Veterans Health Administration (VHA) patients (78,726 person-years), comparing those with ≥30 days of nicotinamide exposure to unexposed individuals.","key_result":"Nicotinamide users had a KC incidence of 0.204 vs. 0.255 per person-year (absolute risk reduction 0.051), preventing 624 KCs annually among 12,287 users. Total nicotinamide cost was $161,451 against $526,032 in treatment cost savings (net savings: $364,581), yielding a dominant incremental cost-effectiveness ratio of **-$58,426 per QALY gained** (19.9% reduction in yearly KC treatment costs). Non-VHA scenario analysis showed a cost of $14,407/QALY—well below standard willingness-to-pay thresholds.","limitations":"- The cohort is 98% male veterans with a mean age ~77 years, severely limiting generalizability to women and younger or non-VHA populations.\n- 1-year time horizon may underestimate long-term cumulative benefits and costs.\n- QALY decrement per KC (0.01) is an assumption; quality-of-life modeling uncertainty may affect absolute ICER values.","practice_takeaway":"For high-risk patients with a history of multiple KCs, oral nicotinamide is cost-saving and clinically beneficial—consider it as a routine preventive option, especially in older adults. Non-VHA cost scenarios still showed cost-effectiveness well under $50,000/QALY, supporting broad applicability."}},{"doi":"10.1001/jamadermatol.2025.0531","pmid":"40047786","title":"Human Papillomavirus Vaccination and Actinic Keratosis Burden","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-03-06T00:00:00.000Z","url":"https://doi.org/10.1001/jamadermatol.2025.0531","source_score":46,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-06-27","doi":"10.1001/jamadermatol.2025.0531","days":"30","issn":"2168-6068","rank":"3","field":"Clinical Medicine","score":"46","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.0531","title":"Human Papillomavirus Vaccination and Actinic Keratosis Burden: The VAXAK Randomized Clinical Trial.","journal":"JAMA 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Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark"}]},{"given":"Stine","family":"Wiegell","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark"}]},{"given":"Peter A.","family":"Philipsen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark"}]},{"given":"Niels Bech","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology, Naestved, Denmark"}]},{"given":"Shadmehr","family":"Demehri","sequence":"additional","affiliation":[{"name":"Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital, Boston"}]},{"given":"Susanne K.","family":"Kjaer","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark"},{"name":"Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}]},{"given":"Merete","family":"Haedersdal","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}]}],"issued":{"date-parts":[[2025,6,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"161","created":{"date-time":"2025-03-06T15:30:26Z","timestamp":1741275026000,"date-parts":[[2025,3,6]]},"indexed":{"date-time":"2025-09-04T14:34:23Z","timestamp":1756996463704,"date-parts":[[2025,9,4]]},"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamadermatology/fullarticle/2831192"}},"subtitle":["The VAXAK Randomized Clinical Trial"],"deposited":{"date-time":"2025-06-18T15:01:17Z","timestamp":1750258877000,"date-parts":[[2025,6,18]]},"issn-type":[{"type":"print","value":"2168-6068"}],"published":{"date-parts":[[2025,6,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1093/bjd/ljad371","key":"doi250010r1","year":"2024","issue":"4","author":"George","volume":"190","first-page":"465","unstructured":null,"article-title":"Global epidemiology of actinic keratosis in the 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Burden","updated":"2025-08-04T14:10:34+00:00","published_date":"2025-03-06","best_oa_location":null}},"created_at":"2025-09-19T18:26:15.728Z","updated_at":"2025-09-19T18:39:13.242Z","tags":[{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"condition","value":"Actinic Keratosis","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"condition","value":"Keratinocyte Carcinoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"modality","value":"Vaccine","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"sample_size","value":"n=70","value_numeric":70},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"warning","value":"Abstract reports new AK and keratinocyte carcinoma outcomes without group-specific counts.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"warning","value":"Single-center, small sample (n=70) may limit generalizability.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.0531","tag_type":"warning","value":"Vaccine brand is not specified in the abstract; only a 9-valent alphapapillomavirus vaccine is named.","value_numeric":null}],"summaries":{"what_studied":"A single-center, parallel, double-blind, randomized sham-controlled trial in Denmark tested whether a 9-valent alphapapillomavirus vaccine reduced actinic keratosis (AK) burden over 12 months in immunocompetent adults with ≥15 AKs in a 50–100 cm2 test area versus saline injections. Vaccinations were given at 0, 2, and 6 months; thick AKs received cryotherapy at months 6 and 9; the primary outcome was percent reduction from baseline AKs at 2, 6, 9, and 12 months.","key_result":"Median AK reduction was greater with HPV vaccine vs sham at month 2 (35% vs 25%; P=.03), month 6 (47% vs 29%; P=.01), month 9 (58% vs 42%; P=.09), and month 12 (58% vs 47%; P=.05). Total AK counts and thick AKs were lower at months 6 and 12 with vaccination, while rates of new AKs (1–2 per month) and keratinocyte carcinomas did not differ over 12 months.","limitations":"Single-center trial with n=70 and 12-month follow-up limits generalizability and long-term inference. Cryotherapy was administered to thick lesions at months 6 and 9 in both arms, which may affect interpretation of lesion counts after mid-trial.","practice_takeaway":"In immunocompetent patients with numerous AKs, 9-valent HPV vaccination reduced existing AK burden over 12 months versus sham, but did not lower new AK formation or keratinocyte carcinomas. Use these findings as emerging evidence when counseling patients about AK management options."}},{"doi":"10.1001/jamadermatol.2024.5750","pmid":"39937504","title":"Immune Checkpoint Inhibitors in Field Cancerization and Keratinocyte Cancer Prevention","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-02-12T00:00:00.000Z","url":"https://doi.org/10.1001/jamadermatol.2024.5750","source_score":74,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-02-18","doi":"10.1001/jamadermatol.2024.5750","days":"30","issn":"2168-6068","rank":"3","field":"Clinical Medicine","score":"74","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2024.5750","title":"Immune Checkpoint Inhibitors in Field Cancerization and Keratinocyte Cancer Prevention.","journal":"JAMA dermatology","methods":"","results":"A total of 23 participants were recruited, of whom 17 (73.9%) were male, with a mean (SD) age of 69.7 (9.6) years. No participants withdrew; however, 4 died during the study due to disease progression. The mean (SD) AK number significantly decreased from 47.2 (33.8) at baseline to 14.3 (12.0) at 12 months (P < .001). Younger patients (8 of 12 [66.7%] vs 4 of 12 [33.3%]; P = .007) and those with a history of blistering sunburn (12 of 12 [100%] vs 0; P = .005) were more likely to reduce their AK numbers by 65% or greater. KC total numbers decreased from 42 in the 12 months before starting ICI therapy to 17 in the 12 months after. The number of cutaneous squamous cell carcinomas decreased from 16 to 5 in the same period.","abstract":"$33","keywords":[],"pubmed_id":"39937504","conclusions":"","publication_date":"2025-02-12T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2024.5750","URL":"https://doi.org/10.1001/jamadermatol.2024.5750","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2830216/jamadermatology_cox_2025_oi_240070_1744811599.52904.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"383","type":"journal-article","issue":"4","score":1,"title":["Immune Checkpoint Inhibitors in Field Cancerization and Keratinocyte Cancer Prevention"],"author":[{"given":"Charlotte","family":"Cox","sequence":"first","affiliation":[{"name":"Dermatology Research Centre, Frazer Institute, Experimental Dermatology Group, University of Queensland, Brisbane, Australia"},{"name":"Department of Dermatology, Princess Alexandra Hospital, Brisbane, Australia"}]},{"given":"Susan","family":"Brown","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre, Frazer Institute, Experimental Dermatology Group, University of Queensland, Brisbane, Australia"}]},{"given":"Euan","family":"Walpole","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Princess Alexandra Hospital, Brisbane, Australia"}]},{"given":"Edwige","family":"Roy","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre, Frazer Institute, Experimental Dermatology Group, University of Queensland, Brisbane, Australia"}]},{"given":"Lea","family":"Dousset","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre, Frazer Institute, Experimental Dermatology Group, University of Queensland, Brisbane, Australia"}]},{"given":"Rahul","family":"Ladwa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Princess Alexandra Hospital, Brisbane, Australia"}]},{"given":"Kiarash","family":"Khosrotehrani","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre, Frazer Institute, Experimental Dermatology Group, University of Queensland, Brisbane, Australia"},{"name":"Department of Dermatology, Princess Alexandra Hospital, Brisbane, Australia"}]}],"issued":{"date-parts":[[2025,4,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"161","created":{"date-time":"2025-02-12T16:00:45Z","timestamp":1739376045000,"date-parts":[[2025,2,12]]},"indexed":{"date-time":"2025-07-16T13:54:21Z","timestamp":1752674061791,"date-parts":[[2025,7,16]]},"subject":[],"abstract":"$34","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamadermatology/fullarticle/2830216"}},"subtitle":[],"deposited":{"date-time":"2025-04-16T15:00:44Z","timestamp":1744815644000,"date-parts":[[2025,4,16]]},"issn-type":[{"type":"print","value":"2168-6068"}],"published":{"date-parts":[[2025,4,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.5694/mja17.00284","key":"doi240070r1","year":"2017","issue":"8","author":"Pandeya","volume":"207","first-page":"339","unstructured":null,"article-title":"The incidence and multiplicity rates of keratinocyte cancers in 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Carcinoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"modality","value":"CTLA-4 Inhibitor","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"modality","value":"PD-1 Inhibitor","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"modality","value":"PD-L1 Inhibitor","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"sample_size","value":"n=23","value_numeric":23},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"warning","value":"KC numbers were derived from excised lesions’ histopathology, which may reflect excision practices.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"warning","value":"Nonrandomized pre/post design without a control group limits causal inference.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.5750","tag_type":"warning","value":"Subgroup denominators (e.g., 12 of 12) are unclear given the total sample size (n=23).","value_numeric":null}],"summaries":{"what_studied":"A single-center prospective cohort of immunocompetent adults (n=23) starting PD‑1/PD‑L1 immune checkpoint inhibitors for any cancer, all with forearm actinic keratoses. AKs were counted at baseline and up to 12 months; keratinocyte carcinoma excisions were compared for the 12 months before vs after therapy.","key_result":"Mean AK count fell from 47.2 to 14.3 at 12 months (P<.001). KC totals dropped from 42 in the prior 12 months to 17 after, and cutaneous SCC from 16 to 5; younger patients were more likely to achieve ≥65% AK reduction (8/12 [66.7%] vs 4/12 [33.3%]; P=.007), as were those with a history of blistering sunburn (12/12 [100%] vs 0; P=.005).","limitations":"Pilot, single-center study with a small sample (n=23) and a pre/post design without a control group; heterogeneous ICI regimens (PD‑1 or PD‑L1 ± CTLA‑4) across cancers; four participants died during follow-up.","practice_takeaway":"For patients already on PD‑1/PD‑L1 therapy, AK burden and KC excisions may decline over 12 months. Do not start ICIs solely for field cancerization prevention based on this pilot; larger controlled studies are needed."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Keratinocyte Carcinoma"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Keratinocyte Carcinoma"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Keratinocyte Carcinoma"}}}]]

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