Cuba. The extension of therapeutic coverage to all municipalities across the country, with the opening of more sites, is the key strategy in the application program for HeberFERON; a one-of-a-kind medicine to treat skin cancer (basal cell carcinoma), developed and produced by Cuba’s Center for Genetic Engineering and Biotechnology (CIGB).
HeberFERONis prescribed for perilesional (intradermal) or intralesional therapies of basal cell carcinoma previously confirmed by a biopsy. The drug can be used as alternative or adjuvant therapy with other treatments (surgical or not), in cases of lesions of any size or clinical subtype and in any high-risk area (area H mask area of face) or locally advanced lesions that are difficult to treat due to local invasion and/or proximity to vital structures such as the eyes and brain.
Dr. Katherine Batista Ochoa, dermatologist in the province of Holguín, told Granma that in order to achieve the goal of extending therapeutic coverage, which began in 2016, a greater number of professionals are being trained with support of the University of Medical Sciences, with maxillofacial surgeons, ophthalmologists and oncologists, as well as dermatologists and a group of specialists in Comprehensive General Medicine (CGM), who are interested in the new therapy and are actively monitoring skin cancer patients.
“Once health personnel are trained, we can facilitate the opening of more clinical sites per municipality. We have 30 clinical sites, in 26 health service areas and four hospitals. This effort allows us to guarantee that at least one institution per municipality will provide HeberFERON therapy,” explained the coordinator of the HeberFERON program in Holguín.
The dermatologist explained that Holguín treated 224 patients in 2019, 80% of whom responded positively. Also contributing to these results were health promotion and prevention activities with the organization of various activities to identify potential patients and disseminate knowledge of the new drug. “I am talking about health fairs, information on local media, and promoting knowledge of HeberFERON among health professionals and the population,” she said. She recalled that a patient, sculptor Argelio Cobiellas, after being treated with HeberFERON, created a website called Movimiento a la Piel de la Esperanza, to provide individuals facing epithelial carcinoma a platform to share information and insights about their experience.
Dr. Vladimir Sánchez Linares, in the province of Sancti Spíritus, expressed a similar opinion: “We had the experience of being part of HeberFERON clinical trials with good results at Camilo Cienfuegos provincial hospital. Based on that, we developed a strategy to work at the primary level of our health care system and train a greater number of physicians.”
He noted stated that Sancti Spíritus is facing has a high incidence rate of skin tumors, with municipalities where a significant number of basal cell carcinoma cases are reported, such as in Cabaiguán. Most of treated patients are of Spanish descent, with very white skin and a predisposition to the disease. A similar situation exists in Trinidad, a coastal area that includes the cities of Casilda, Yaguajay and Tunas de Zaza, with a large population of workers in agriculture and fishing.
“We are carrying out a targeted survey in these areas. We found people who had undergone surgery previously and with facial scars, as well as other patients who had experienced re-occurrences and several who had refused surgery. On the basis of this survey, we treated 165 individuals in 2019, of whom more than 90 recovered completely, demonstrating the effectiveness of HeberFERON,” Dr. Vladimir Sánchez reported.
The main challenge is to involve more professionals, who see surgery as the first option to treat skin cancer, Dr. Sánchez continued, adding that he believes these colleagues must have their own experiences to develop confidence in the new product, which is effective in regenerating damaged tissue. “For example, a lesion on the ear pinna usually leads to amputation, thus the ear is mutilated, but with the use of HeberFERON we can avoid cutting off pieces of that part of the body,” he said.
Dr. Yisel Piña Rodríguez, an expert dermatologist in Matanzas, reported that, in order to promote the advantages of HeberFERON in her province, training sessions are being held and events organized for professionals and patients to share experiences. She stated that all hospitals in Matanzas have opened clinical sites, while eight polyclinics in the 13 municipalities are also using the therapy, allowing a total of 341 patients to be treated in 2019.
“I think the impulse of the directors has been important, but we doctors who joined the program are the vital link.”
“This is a drug that has revolutionized epithelial tumor treatment, since surgery has always been considered as the main option for treating patients with basal cell carcinoma. Other very expensive pharmacueticals exist around the world that Cuba cannot afford to purchase. HeberFERON is similar to these international products.”
HeberFERON mixes two types of interferons: alpha and gamma, for effective treatment of basal cell carcinomas, a very common and high incidence skin cancer around the world. These tumors arise on the nose, ears, eyelids, facial areas around the eye and on the chest and back neckline.
This cancer evolves rapidly and is detectable when an abnormal formation of a tumoral nature is observed at the basal layer of the epidermis. They are generally seen in areas exposed to the sun or humidity.
Basal cell carcinoma is most commonly seen in older adults who have worked outdoors, in agriculture, fishing or sports training.
Those with a family history of skin cancer and known genetic factors often experience recurrent carcinomas.
Specific skin type more vulnerable; individuals with very fair skin, light eyes and hair are more likely to develop this type of carcinoma.
Patients with dark complexions and under 40 years of age are now being seen, due to the effects of climate change and damage to the ozone layer, which have led to greater exposure to ultraviolet rays for those living in the tropics.
Basal cell carcinoma has a significant impact in Cuba, where some 4,000 cases are reported each year.