Two years ago, Dr. Anna Nichols, a dermatologist at the Sylvester Comprehensive Cancer Center, treated a 97-year-old woman whose right leg was covered with squamous cell tumors. Though surgery is usually the standard of care for patients with skin cancer, Dr. Nichols was unable to operate due to the extension of the tumors.
“She was not a candidate for surgery because of the sheer number and size of her tumors. She wasn’t a candidate for radiotherapy, again for the same reasons,” said Dr. Nichols, who is also an assistant professor at the University of Miami Miller School of Medicine.
Squamous cell carcinoma is the second-most-common form of skin cancer. Evidence shows the human papillomavirus (HPV) may play a role in the development of some types of this skin cancer. There is, however, very little research suggesting that an HPV vaccine could fight existing tumors.
Nonetheless, Dr. Nichols had written a case report shedding new light on the potential of reducing the number of new basal and squamous cell skin cancers with the HPV vaccine Gardasil. Therefore, when her patient was unable to undergo surgery, Tim Ioannides, a voluntary faculty member at UM, suggested using Gardasil as a treatment by injecting the vaccine directly into the tumors.
Given that her patient had no other options, Dr. Nichols proposed trying the vaccine. The treatment was considered an “off-label” use because Gardasil is only approved for the prevention of cervical, anal, and genital cancers caused by the human papillomavirus.
“I think we had a really reasonable expectation and good data that this was actually going to, at the very least, do no harm to this patient, and possibly provide some benefit,” Dr. Ioannides said. “To have this type of result in such an advanced patient I think was beyond all our expectations.”
The patient received two doses of the 9-valent HPV vaccine, six weeks apart. Afterward, Dr. Nichols directly injected several of the patient’s tumors four times over the course of 11 months. “All of her tumors completely resolved 11 months after the first direct tumor injection, and she has had no recurrence,” Dr. Nichols said. “It has been about 24 months now since we started with the treatment.”
“They decided to try it and it worked. It killed them all off,” said the patient, who will celebrate her 100th birthday this fall.
Nichols, whose report on the squamous cell tumors case was eventually published online in JAMA Dermatology, hopes the success of the treatment will lead to additional research into the use of the vaccine as a treatment for skin cancer.