# SCIN (curettage then imiquimod against excision for nodular basal cell carcinoma)

Source: https://onco.cc/trials/scin-trial/  
OnCo record `scin-trial` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Scraping the lump off first and then using the cream was tested against simply cutting it out, for the thicker kind of basal cell carcinoma. It did not come close: about one in five of those treated without surgery had the tumour back within five years, against one in fifty after the operation.

## Summary

The creams are licensed for the thin superficial form of basal cell carcinoma. SCIN asked whether they could be stretched to the commoner nodular form by scraping the visible tumour away first, on the reasoning that curettage removes the bulk and the cream deals with what is left. Two Dutch dermatology departments randomised 145 patients with a primary nodular basal cell carcinoma of 4 to 20 mm between January 2016 and November 2017, 73 to superficial curettage followed by imiquimod and 72 to surgical excision. Follow-up finished in September 2022.

Fifteen treatment failures occurred in the curettage and imiquimod group, five of them between one and five years, against one in the surgery group. The probability of remaining free from treatment failure at five years was 77.8 per cent after curettage and imiquimod (95 per cent confidence interval 65.7 to 86.0) against 98.2 per cent after excision (88.0 to 99.8). The relative risk of treatment failure was 15.93 (2.10 to 120.64), and its confidence interval does not exclude the pre-specified non-inferiority margin of 5.22, so non-inferiority could not be concluded. Twenty patients died of causes unrelated to the skin cancer during follow-up; accounting for that as a competing risk gave a subhazard ratio of 16.16 (2.18 to 119.72).

The authors' own reading is worth keeping, because it is the honest version of a negative trial: most failures happened in the first year, and a person who is still clear a year after curettage and imiquimod has a 77.8 per cent chance of staying clear at five. That is a real option for someone who cannot or will not have an operation on the face. It is not equivalence.

## Fields

- Kind: Trial
- Status: negative
- Last checked: 2026-09-25
- Also known as: SCIN; Surgery versus Combined treatment with curettage and Imiquimod for Nodular basal cell carcinoma
- Registry id: NCT02242929
- Phase: 3
- Setting: Primary nodular basal cell carcinoma of 4 to 20 mm: superficial curettage followed by imiquimod 5 per cent cream against surgical excision, with freedom from treatment failure at one year as the primary outcome and at five years as a pre-specified secondary outcome
- Sponsor: Maastricht University Medical Centre
- Enrolled: 145
- Result: Freedom from treatment failure at five years 77.8 per cent after curettage with imiquimod against 98.2 per cent after surgical excision; relative risk of failure 15.93 (95 per cent confidence interval 2.10 to 120.64), non-inferiority not concluded.
- Outcomes: Free from treatment failure at 5 years: Superficial curettage then imiquimod 77.8% vs Surgical excision 98.2%
- Replication: Consistent with SINS, where imiquimod given for twelve weeks for nodular disease without curettage was also inferior to excision.

## Sources

- ClinicalTrials.gov NCT02242929: https://clinicaltrials.gov/study/NCT02242929
- Five-year results (JAMA Dermatology 2025): https://doi.org/10.1001/jamadermatol.2024.5572
- Five-year results on PubMed: https://pubmed.ncbi.nlm.nih.gov/39878970/

## Connected records

- cancers: [Basal cell carcinoma](https://onco.cc/cancers/basal-cell-carcinoma/), [Skin cancer (all types)](https://onco.cc/cancers/skin-cancer/)
- drugs: [Imiquimod](https://onco.cc/drugs/imiquimod/)
- terms: [Creams, light and cold for basal cell carcinoma](https://onco.cc/terms/topical-and-destructive-treatment-bcc/), [Curettage and cautery](https://onco.cc/terms/curettage-and-cautery/)
- trials: [Photodynamic therapy against imiquimod against fluorouracil for superficial basal cell carcinoma](https://onco.cc/trials/mal-pdt-imiquimod-fluorouracil-superficial-bcc/), [SINS (surgical excision against imiquimod cream for basal cell carcinoma)](https://onco.cc/trials/sins-trial/)

---
JSON: https://onco.cc/api/v1/entities/scin-trial.json