The game-changing skin cancer treatment for localised non-melanoma skin cancer

A new treatment for localised non-melanoma skin cancer (NMSC), which offers an alternative to surgery or conventional radiotherapy for lesions in functionally and cosmetically sensitive areas, is helping to tackle the 100,000 hospitalisations which occur annually as a result of the condition.

Rhenium-SCT (Skin Cancer Therapy) developed by Oncobeta, is an ARTG-registered medical device that is indicated for superficial cutaneous squamous and basal cell carcinomas.

Effective, safe and non-invasive, the therapy can achieve excellent cosmetic outcomes – essential for NMSC patients for whom surgical intervention is known to negatively affect quality of life.

Radiation oncologist and Chief Medical Officer for Oncobeta (APAC), Dr Sid Baxi, says that while surgery remains the standard option for localised NMSC, it is not always the most appropriate option. Likewise, conventional radiotherapy requires an extended treatment course over several weeks that is not practical for some patients.

“As we get older, the incidence of skin cancer and the necessary interventions increase dramatically, creating a substantial burden on our elderly patients.” Dr Baxi explained.

“There are circumstances where surgery is deemed unfavourable, either by the surgeon for medical or technical reasons, or by the patient due to cosmetic or functional reasons particularly the nose, ears, eyes, lips, and forehead. In these instances, Rhenium-SCT can be a great alternative.”

With almost 70 percent of Australians expected to have at least one NMSC excised in their lifetime – and over 1-millon Medicare services used annually for NMSC – access to effective, non-surgical treatment options is essential.

How does it work?

Rhenium-SCT harnesses low-penetrating beta radiation, which penetrates only a few millimetres of skin, thereby treating the tumour whilst avoiding unnecessary exposure of normal tissue.

Achieving complete response rates > 95 percent from a single treatment, Rhenium-SCT is applied as a paste thereby allowing for conformal application to complex surfaces that may otherwise require complex surgery.

“The clinician applies the paste over an adhesive film using an applicator that resembles a paint brush. The patient sits comfortably and painlessly during treatment, the duration of which is personalised based on lesion factors. Once complete, the patient can immediately return to regular activity.”

“Over the following weeks, the treated lesion will become mildly inflamed, eventually scabbing over before healthy tissue appears.”

Which patients are suitable?

Dr Baxi says appropriate patients are those who are not suitable for surgery or conventional radiation therapy – perhaps with challenging lesions on the head and neck region.
The paste can be applied anywhere on the body, including sensitive sites like the nose, lips, around the mouth and ears. It is particularly suitable for complex areas that may be difficult to target via surgery.

“I have also treated patients on the lower limb, where it might have been difficult to do a surgery with a graft successfully. We just have to consider the patients general health and local blood supply to make sure they can adequately heal.”

Considerations

While more convenient than conventional radiotherapy, Rhenium-SCT is still a form of radiation therapy. For this reason, it will not be suitable for patients who are at high risk of developing radiation therapy-induced side effects, such as Scleroderma.

“There are also those with potentially poor healing– due to conditions such as diabetes or generally poor vascular supply. Such patients face challenges with most treatments, although we would nonetheless exercise caution when using Rhenium-SCT with this cohort.”

Dr Baxi emphasises that Rhenium-SCT is not intended to supplant the role of conventional treatments, but rather offer choice to people diagnosed with NMSC, whilst offer skin cancer practitioners another option in the toolbox.

“It’s a matter of giving the patient options in how they’d like to have their cancer managed.”

Progress

Since 2021 Dr Baxi and colleagues have taken part in a prospective multinational clinical trial called EPIC-Skin, consisting of 180 patients, which investigates the efficacy, side effects and patient reported outcomes of Rhenium-SCT.

The six-month results of that study are currently under peer review demonstrating a >97 percent complete response rate – i.e., resolution of the tumour – and an acceptable safety profile. Dr Baxi and colleagues continue to follow these same patients for a further 2 years, with 12-month results expected shortly.

Another recent study revealed that a majority of patients who have been treated with both Rhenium-SCT and surgery, indicated they prefer Rhenium-SCT. Patient preference is a critical consideration for NMSC treatment given the burden of disease. This underscores the need for broad access for suitable patients.

As Rhenium-SCT is currently not listed for Medicare reimbursement, most patients incur the full cost of treatment. Oncobeta is engaged in the MSAC process with the goal of improved patient access through subsidised treatment in the future. Encouragingly, certain private health funds are of offering to subsidise treatment for certain patients for whom there is a clear benefit over surgery or fractionated radiation therapy.

“We are hoping that all patients will soon have access to subsidised treatment to ensure broad access across the country to those who need it.”

Further insight

Sharing further details of the treatment, outcomes and other updates Dr Baxi will present at the upcoming Health Insurance Summit, hosted by Informa Connect.

This year’s event will be held 24-25 June at the Grand Hyatt Melbourne.

Register your tickets here.

About Siddhartha Baxi

A/Prof Sid Baxi is a trailblazer in the delivery of personalised cancer care. His work established a cancer care network specifically tailored for Indigenous communities in the Northern Territory. Over the past decade, this initiative has championed culturally appropriate cancer care for First Nations people across the region.

A/Prof Baxi currently works a Radiation Oncologist working within the cancer care network of specialists at John Flynn Hospital, Gold Coast and Tweed Hospital. Sid is the Regional Medical Director, as well as the Director of IT, Innovations and Platforms for GenesisCare Australia.

A/Prof Baxi is also the Medical Director for OncoBeta Therapeutics. As one of the first treating clinicians of Rhenium-SCT® in Australia, A/Prof Sid Baxi provides OncoBeta®. When Sid encountered Rhenium-SCT® he saw its compelling value for patients. His participation in the EPIC clinical trial solidified his conviction. His vision? To make Rhenium-SCT® an affordable and accessible treatment for all Australians.