A cream could treat the biggest killer cancer in organ transplant patients 

TRI-based University of Queensland scientists are working to develop a new topical cream to treat deadly skin cancers in organ transplant patients.

Immunosuppression in organ transplant recipients greatly increases their risk of keratinocyte cancer (KC). They are 100 times more likely to develop skin cancers than the general population*, and it’s one of their leading causes of death in Australia.**  

Professor Kiarash Khosrotehrani, of UQ’s Frazer Institute (formerly UQ Diamantina Institute), Dr Sharene Chong, PhD student Ho Yi (Bonnie) Wong and their team, are clinically testing a topical sirolimus cream to prevent facial skin cancers like basal and squamous cell carcinomas, in this vulnerable population.

Sirolimus is used in organ transplant patients as an anti-rejection medication and to prevent the onset of skin cancer. But it’s quite poorly tolerated. In the pilot study, Professor Khosrotehrani’s research team found it’s effective as a cream to fight the cancers without major side effects.

“In the pilot study and research, we saw a three-to-four-fold reduction in skin cancers in patients who used the cream on their hands and forearms. It had minimal side effects and didn’t impact the commonly prescribed anti-rejection drugs,” Professor Khosrotehrani said.

Buoyed by the results of the pilot study, the group has funding to conduct a large clinical trial.

“We’re now doing this bigger study to test the cream on the face, where some of the deadliest, nastiest skin cancers are found, and on the scalp.”

The research team was awarded $2.5 million from the Medical Research Future Fund to undertake the new ‘Siroskin’ clinical trial.

Around 150 participants who’ve had an organ transplant and multiple skin cancers, across Brisbane, Sydney, and Melbourne, will be taking part in the trial.

“We hope to dramatically reduce the skin cancers and increase patients’ life expectancy and health outcomes,” Professor Khosrotehrani said.

He’s driven to find a treatment after seeing many of his patients undergoing multiple surgeries to remove the cancers.

“We see them every three months, and every three months you remove a dozen skin cancers. Then they leave and return with another 10,” Professor Khosrotehrani explained.  

“It’s constant care. They can’t move on with their lives, returning to the doctors to have the dressing changed and stitches removed post-surgery. We desperately need solutions, and we really hope this cream can be one.”

During the trials, alongside safety tests, the cream’s texture is being refined for patients to easily apply and use long term.

“This could be a game-changing cancer-preventative cream and it’s very well tolerated compared to alternatives. We’re focused on finalising our clinical tests and moving to the next stage,” Professor Khosrotehrani said.

The study was published and printed in the November 2022 edition of the Journal of the American Academy of Dermatology.

The pilot study was funded by Metro South Health’s SERTA scheme.

The coordinating centre for the trial is Melanoma and Skin Cancer Trials (MASC Trials). You can register to participate in the trial at the MASC Trials SiroSkin website. 

*University of California San Francisco | Organ transplant and skin cancer risk

**The University of Adelaide News | Transplant patients have high rates of cancer death