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Basal cell carcinoma (BCC) is the most common cutaneous malignancy with a favorable prognosis, as the estimated cure rate when treated early is around 95%. 1 Despite this, BCC can progress locally or metastasize. Vismodegib has been shown to lead to significant improvement in patients with advanced BCC. 2 Unfortunately, adverse effects (AE) have often led to drug discontinuation. 2,3 Multiple-month drug holidays were introduced in patients with basal cell nevus syndrome with increased drug tolerability. 4,5 To our knowledge, there has been no report regarding the use of weekly intermittent dosing of vismodegib. This study evaluates a novel alternate dosing regimen of vismodegib that has led to decreased toxicity and eliminates the need for a loading dose.Methods | This retrospective study was approved by the institutional review board at the University of Minnesota. Informed consent was not required as all data were deidentified. We included patients seen in the Department of Dermatology at the University of Minnesota with confirmed BCC who were on an intermittent dosing regimen of vismodegib. Patient age, sex, BCC status, dosing schedule, length of treatment, treatment response, clinical photos, and AEs were compiled from the electronic medical record.1 wk/3 wks × 5 cycles 9 Resolution Fatigue Abbreviations: BCC, basal cell carcinoma; IVT, intermittent vismodegib therapy; MMS, Mohs micrographic surgery.