A meta-analysis of treatment effects of imiquimod for basal cell carcinoma.

Abstract

We conducted this meta-analysis to assess the efficacy and safety of imiquimod in comparison with other treatments in patients with BCC. A comprehensive literature search was performed in the database of PubMed, Embase, and Web of Science. Outcomes of interest included histological/composite clearance rate, success rate, complete response rate, tumor free survival, and adverse events. Pooled risk ratio (RR) with 95% confidence intervals (CIs) using a fixed-effects or random-effects model were determined for each outcome. A total of 13 studies involving 4256 patients were identified. Imiquimod was associated with significantly higher histological clearance rate (RR=9.28, 95%CI: 5.56, 15.49; P<.001) and composite clearance rate (RR=34.24, 95%CI: 21.29, 55.06; P=.001). Moreover, imiquimod also significantly increased complete response rate (RR=3.15, 95%CI: 1.55, 6.38; P=.001) but had no effect in the success rate (RR=0.98, 95%CI: 0.89, 1.08; P=.727) and probability of tumor-free survival (RR=1.15, 95%CI: 0.98, 1.35; P=.088), as compared with other treatments. There were more patients in imiquimod group who developed adverse events than in other treatment group (RR=2.00, 95%CI: 1.39, 2.88; P<.001). This study indicated the effects of imiquimod in improving the histological/composite clearance rates as compared with other treatments. However, its treatment-related adverse events also should be noticed. Our findings supported that, imiquimod could be used as the first-choice treatment for BCC.