Photodynamic Therapy Using Methyl-5-Aminolevulinate Hydrochloride Cream in Determining Pain Threshold in Patients With Skin Cancer

PRIMARY OBJECTIVES: I. To determine the "low" initial irradiance that causes no or minimal
(pain grade of < 4) during the time period during which 90 +/- 10% photo bleaching of
protoporphyrin IX (PplX) in the lesion occurs, and which precedes the "high" irradiance
portion of MAL/PDT. II. To determine the effects of preceding "low" irradiance on the pain
level of the "high" irradiance portion of MAL-PDT. SECONDARY OBJECTIVES: I. To determine
the effects of irradiance on lesion perfusion. II. To determine PpIX and Total Vit D
content in blood. TERTIARY OBJECTIVES: I. To monitor the clinical outcomes of the
treatments for initial response and recurrences. OUTLINE: Patients are randomized to 1 of
2 treatment arms. GROUP I: Patients apply methyl-5-aminolevulinate hydrochloride (MAL)
cream on the lesions and the surrounding normal skin. Beginning 3 hours later, patients
undergo laser light treatment for 3-5 minutes. GROUP II: Patients apply MAL cream on the
lesions and the surrounding normal skin. Beginning 3 hours later, patients undergo
light-emitting diode treatment for 10-20 minutes. After completion of study treatment,
patients are followed up at 5-7 days, at 6-12 months, and at 24 months.

Inclusion Criteria:

- Patients with 1-2 superficial basal cell carcinoma (sBCC), 0.5 to 2 cm in diameter

- Primary or recurrent lesions may be treated

- Diagnosis must be confirmed by biopsy, at least 2 weeks pre treatment

- Each patient with < 8 lesions can contribute a maximum of 2 lesions per treatment
session, 1 lesion per light source, which can be treated the same day as permitted by
scheduling; the remaining lesions may be treated as soon as scheduling permits with
non protocol Photodynamic Therapy

- Patient or legal representative must understand the investigational nature of this
study and sign an Independent Ethics Committee/Institutional Review Board approved
written informed consent form prior to receiving any study related procedure

Exclusion Criteria:

- Patients not meeting the above selection criteria

- Lesions which are not suitable for diagnostic measurements

- Patients with >= 8 lesions to be treated

- Carcinomas of types known to have uncertain clinical margins (e.g. morpheaform or
infiltrating), or any lesion felt to require Mohs surgery for definitive control

- Lesions over boney prominences

- Patients with porphyrias or known hypersensitivity to porphyrins

- Patients with known photosensitivity diseases

- Patients with allergies to Metvixia (MAL) cream ingredients (peanut and almond oil)

- Patients previously treated with a systemic photo sensitizer within 4 months

- Pregnant or nursing female patients

- Patients unwilling or unable to follow protocol requirements

- Any condition which in the Investigator's opinion deems the patient an unsuitable
candidate to receive study drug