Medicus Microneedling-Based Therapy Enters Clinical Evaluation for Basal Cell Carcinoma: perspective of a board-certified Mohs surgeon

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HEADLINE

Medicus Microneedling-Based Therapy Enters Clinical Evaluation for Basal Cell Carcinoma

SUMMARY

A novel microneedling-based drug delivery platform is being investigated as a potential non-surgical treatment for basal cell carcinoma (BCC). New York Mohs surgeon Dr. Dennis Porto comments on the promise and limitations of this investigational approach as early trial data emerge.

BACKGROUND: BASAL CELL CARCINOMA AND CURRENT TREATMENTS

Basal cell carcinoma (BCC) is the most common cancer in humans, with millions of new cases diagnosed in the United States each year. The cornerstone of treatment is surgical removal, with Mohs micrographic surgery offering the highest cure rates due to its complete margin assessment and tissue-sparing methodology.

Other treatment options include standard excision, topical therapies, electrodessication and curettage, radiation, photodynamic therapy, and—rarely—systemic hedgehog pathway inhibitors for advanced disease. However, the rising incidence of BCC has stretched dermatologic surgical capacity and increased interest in less invasive therapeutic innovations.

NEW DEVELOPMENT: THE MEDICUS MICRONEEDLING TRIAL

Medicus is developing a novel microneedling-based delivery platform intended to enhance penetration of anti-cancer agents directly into BCC lesions. The approach uses precision microneedles to create controlled microchannels in the lesion, allowing targeted intralesional delivery of therapeutic compounds without systemic exposure.

Early-stage clinical trials are assessing feasibility, safety, and preliminary efficacy for superficial and nodular BCCs. Investigators hope that enhanced local drug delivery may offer select patients a non-surgical alternative, particularly when surgery is contraindicated or cosmetically challenging.

Thus far, trial updates have highlighted:

- Successful administration across multiple BCC subtypes

- Minimal procedural downtime

- Early signals of lesion regression in certain cases

- Continued need for long-term data to evaluate clearance durability and histologic outcomes

These findings are preliminary, and the therapy remains investigational.

EXPERT COMMENTARY

“BCC is the most common cancer in humans. However, there are so few of us board-certified Mohs surgeons in the United States that resources are often stretched thin as more and more people require treatment. While I am always interested in novel approaches that may result in a reasonable treatment for certain patients, Mohs micrographic surgery remains the only treatment that allows full margin assessment and thus has been shown time and time again to have the highest cure rate for skin cancer. I'm eager to see more study results in this microneedling investigation,” said Dr. Dennis Porto, MD, MPH, FAAD, a Mohs surgeon and dermatologist in New York City.

CLINICAL SIGNIFICANCE AND OUTLOOK

If future trials demonstrate high clearance rates and durable responses, microneedling-based delivery could become an option for carefully selected BCC patients—particularly those who cannot undergo surgery or who prefer a non-surgical approach for cosmetic or medical reasons.

However, Mohs surgery will remain the gold standard for the vast majority of cases, especially for high-risk sites, aggressive subtypes, and recurrent tumors. As evidence grows, clinicians will be watching closely to determine where microneedling technologies may fit in the broader skin-cancer treatment landscape.

ABOUT DR. DENNIS PORTO

Dr. Dennis Porto, MD, MPH, FAAD, is a double board-certified Mohs micrographic surgeon and dermatologist practicing in New York City. He trained at the University of Iowa and completed a dermatology research fellowship at Harvard before advanced surgical specialization. Dr. Porto is a clinical assistant professor of dermatology at Mount Sinai and has published widely in dermatologic surgery, skin-cancer therapy, and procedural innovation. His practice combines medical, surgical, and emerging technologies to advance evidence-based skin-cancer care.