Targeted and immunotherapy drugs for skin cancer

Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune聽system to attack聽cancer. They are called immunotherapies.

Some drugs work in more than one way.聽So they are targeted as well as working with the immune system.聽

The main targeted drugs and immunotherapy for skin cancer are:

This page is about targeted drugs and immunotherapy for non melanoma skin cancer

For skin cancer you might聽have one of the following treatments:

Imiquimod cream

You might have聽imiquimod cream as a treatment if you have basal cell carcinoma (BCC) in the top layer of skin or actinic keratosis. Actinic keratosis is a skin condition that聽can develop into a squamous cell carcinoma (SCC) over time.

Cemiplimab聽(Libtayo)

Cemiplimab聽(Libtayo) is a type of immunotherapy called a checkpoint inhibitor.聽

You might have cemiplimab for SCC聽if:

You might have cemiplimab for BCC if:

Locally advanced means the cancer has spread to deeper layers of skin or nearby lymph nodes and you can't have surgery.

Vismodegib (Erivedge)

You might have vismodegib under the cancer drugs fund if you have lots of basal cell carcinomas (BCCs).聽

Vismodegib has a drug license for basal cell carcinoma (BCC) that has spread to another part of the body (metastatic). Or for BCC that is locally advanced and surgery or radiotherapy are not possible.

But it is not available on the NHS for locally advanced or metastatic BCC. We have more information about this below.聽

Imiquimod cream uses your body鈥檚 natural defences to help聽kill the skin cancer cells. It聽works by releasing a number of chemicals called cytokines. One of these cytokines is called interferon.

Interferon聽is a protein that the body makes as part of the immune response. Interferon is also used as a cancer treatment. It is thought that imiquimod makes cells produce more interferon which destroys the skin cancer cells.

Cemiplimab (Libtayo) is a type of immunotherapy called a checkpoint inhibitor.

Cemiplimab聽works by blocking a protein that stops the immune system from working properly and attacking cancer cells. It聽helps to make聽your immune system find and kill cancer cells.聽聽

Vismodegib (Erivedge) is a type of targeted drug called a cancer growth blocker.聽It works by targeting and switching off a group of proteins. This stops the growth of the cancer.

New cancer drugs are聽licensed聽for use聽in a particular way.聽 For example, a drug might have a license to treat a particular stage or type of skin cancer.聽

Once a drug has a license, several independent organisations聽approve the new cancer drugs before doctors can prescribe them on the NHS.

In聽England聽the National Institute for Health and Care Excellence (NICE) decides which drugs and treatments are available on the聽NHS.

In聽Wales, the All Wales Medicines Strategy Group (AWMSG) advises聽NHS Wales. They generally聽follow NICE decisions but can also issue their own guidance,

The Scottish Medicines Consortium (SMC) advises聽NHS聽Scotland. Its decisions are separate from decisions made by NICE.

The Department of Health advises about health and social care in聽Northern Ireland.聽They usually follow NICE decisions.

Imiquimod and cemiplimab are both widely available throughout the UK.

Vismodegib has a drug license for basal cell carcinoma (BCC). But NICE and the SMC have not聽recommended vismodegib as a skin cancer treatment. So it is not widely available in the UK.

England, Wales and Northern Ireland

Vismodegib is聽available for some people through the cancer drugs fund in England.聽Medicines on the Cancer Drugs Fund in England are also usually made available to patients in Wales and Northern Ireland.聽

Under the cancer drugs fund, you might be able to have vismodegib:

This means it hasn't spread to distant parts of the body (metastatic) and it hasn't spread聽into nearby tissue or lymph nodes (locally advanced).聽

And you must also:

You might still be able to have vismodegib if you have Gorlin syndrome and you are not able to have surgery.

Scotland

In Scotland, vismodegib is not available at the moment.聽

You have:

You put the cream on yourself at home.

To treat BCC, you usually put imiquimod cream on to the affected area once a day. You do this 5 days a week for 6 weeks. You usually leave the cream on the skin for about 8 hours. You shouldn't shower or bathe during this time.聽

You have聽the treatment through a drip into your arm. A nurse puts a small tube (a cannula)聽into one of your veins and connects the drip to it.

You may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you鈥檙e having treatment, which may be for a few months.

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

Everyone is different and the side effects vary from person to person. The side effects you have depend on:

A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on.聽For more information about the side effects of your treatment, go to the individual drug pages.

We don't have a page about cemiplimab or vismodegib at the moment.

You can read some general information about the side effects of checkpoint inhibitors in our immunotherapy section.聽

You can read some general information about the side effects of cancer growth blockers in our targeted cancer drug section.

British Association of Dermatologists Guidelines for the management of adults with basal cell carcinoma I. Nasr and others British Journal of Dermatology, 2021

Cemiplimab for treating advanced cutaneous squamous cell carcinoma [TA802] National Institute for Health and Care Excellence, accessed June 2022

Electronic Medicines Compendium,聽 Accessed February 2023

Non-melanoma skin cancer: United Kingdom National Multidisciplinary Guidelines C Newlands and others J Laryngol Otol. 2016 May; Volume 130(Suppl 2): Pages S125鈥揝132