Biomarker Expression Linked to Aggressive Basal Cell Skin Cancer Interview with:

Alon Kahana, MD, PhD Associate Professor Kellogg Eye Center University of Michigan

Dr. Alon Kahana

Alon Kahana, MD, PhD
Associate Professor
Kellogg Eye Center
University of Michigan What is the background for this study? What are the main findings?

Dr. Kahana:
Basal cell carcinoma is the most common cancer – more common than all other cancers combined. Fortunately, it is usually not aggressive, and can be easily treated surgically. However, when it is on the face, or when it has grown to a large size, it can become very disfiguring and even deadly. Basal cell carcinoma is diagnosed histopathologically, yet molecular diagnostics have proven value in a variety of cancers. In order to improve diagnosis and care, we set out to test whether histologically aggressive forms of basal cell carcinoma are associated with increased cell proliferation.

Furthermore, we tested whether expression of the epigenetic regulator Ezh2 is associated with higher-grade carcinoma and/or with increased proliferation. The breakthrough discovery is that expression of Ezh2 correlates with high proliferation and with aggressive histologic features, suggesting that epigenetic regulators can be used both as markers of disease severity and targets of novel therapy. What should clinicians and patients take away from your report?

Dr. Kahana: Basal cell carcinoma can lead to tumors that have aggressive features, making them harder to treat. Having histologic and molecular markers for more aggressive variants can be used for treatment planning, and also to identify molecular targets for novel therapies. Particularly when basal cell carcinoma is around vital organs, such as the eye, having targeted therapy could improve outcomes. What recommendations do you have for future research as a result of this study?

Dr. Kahana: This is the first step in our efforts to characterize genetic pathways that correlate with aggressive basal cell carcinoma. The next steps are to
(1) correlate molecular markers with response to medical treatment (e.g. hedgehog inhibitors) vs. surgical excision,
(2) continue to identify genetic pathways that mark more aggressive tumors, and
(3) conduct clinical trials for drugs that target aggressive basal cell carcinoma. Is there anything else you would like to add?

Dr. Kahana: Basal cell carcinoma is common yet considered relatively benign. However, the toll on public health and healthcare expenditures, as well as the consequences of this cancer in terms of disfigurement and loss of function, should not be underestimated.


Rao RC, Chan MP, Andrews CA, Kahana A. EZH2, Proliferation Rate, and Aggressive Tumor Subtypes in Cutaneous Basal Cell Carcinoma. JAMA Oncol. Published online April 07, 2016. doi:10.1001/jamaoncol.2016.0021.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on



Last Updated on April 21, 2016 by Marie Benz MD FAAD