Efficacy of Vismodegib for the Treatment of Orbital and Advanced Periocular Basal Cell Carcinoma

Eiger-Moscovich, Maya; Reich, Ehud; Tauber, Gil; Berliner, Ori; Priel, Ayelet; Simon, Guy Ben; Elkader, Amir Abd; Yassur, Iftach

doi:10.1016/j.ajo.2019.04.013

Cited by 33 publications

(46 citation statements)

References 21 publications

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“…There is a paucity of data on the outcomes of vismodegib treatment for locally advanced periocular BCC. Small prospective and retrospective series report complete response rates between 25 and 67% with only 13% showing no response in one study [5][6][7]. In the present series 38% (five patients) demonstrated a complete response to vismodegib, with the rest demonstrating a partial response.…”

Section: Discussionmentioning

confidence: 44%

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Vismodegib for periocular basal cell carcinoma: an international multicentre case series

Oliphant

Laybourne

Chan³

et al. 2020

Eye

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Introduction Vismodegib (Erivedge, Genentech) is a first-in-class inhibitor of the hedgehog (Hh) pathway, which is licensed for use in locally advanced basal cell carcinoma (BCC) and metastatic BCC. The National Institute for Health and Care Excellence withdrew recommendation for use of vismodegib secondary to a lack of data comparing vismodegib to standard supportive care. The purpose of this multicentre, international case series is to report outcomes of patients with locally advanced periocular BCC who have been treated with vismodegib. Methods The medical records of all patients treated with vismodegib were retrospectively reviewed across seven institutions in the United Kingdom, Australia, and New Zealand. Results Thirteen patients were identified. Seven (54%) patients were male. All BCCs were ill-defined, with seven (58%) having orbital involvement at presentation. Median treatment time was 7 months (range 2-36 months). Eleven out of 13 patients developed side effects, the most common being fatigue in six patients (46%). Median follow-up was 24 months (range 12-48 months). Complete response was found in 5/13 patients (38%) and a partial response in 8/13 patients (62%). Six patients had further surgery after vismodegib, with three classed as globe-sparing operations. Three patients developed recurrence (23%). Three patients (23%) ultimately underwent exenteration. Discussion This study demonstrates vismodegib to be a well-tolerated treatment which may, in some cases, facilitate globesparing surgery and hence avoid disfiguring operations such as exenteration. Uncertainty does remain regarding the longterm outcomes of patients treated with vismodegib.

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Section: Discussionmentioning

confidence: 44%

“…However, vismodegib continues to be widely used in other countries for cases of locally advanced and metastatic BCC. It has also been shown to have utility in locally advanced periocular BCC [4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Vismodegib for periocular basal cell carcinoma: an international multicentre case series

Oliphant

Laybourne

Chan³

et al. 2020

Eye

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“…The pivotal study, a prospective nonrandomized clinical trial, revealed a 43% response rate among patients with locally advanced BCC and 30% response rate among patients with metastatic BCC, with a median duration of response of 7.6 months [ 8 ]. Prospective trials have assessed vismodegib as a neoadjuvant in a variety of body locations [ 17 , 18 , 19 ], and several case studies have highlighted the efficacy of vismodegib for preserving vision in patients with orbital BCC [ 20 , 21 , 22 , 23 , 24 , 25 ]. More recently, post hoc prospective analysis of the multisite multicountry Safety Events in Vismodegib study data showed either complete or partial response to vismodegib in 67% of patients [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Vismodegib for Preservation of Visual Function in Patients with Advanced Periocular Basal Cell Carcinoma: The VISORB Trial

et al. 2021

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“…It may lead to severe birth defects or fetal death (12). An application in metastatic cases is "off label" as this was not included in the indication area due to low response (13)(14)(15)(16). Resistance to Vismodegib has been reported, although the incidence does not appear to be very high (e.g., <10% in a study with 207 patients).…”

Section: Hedgehog-inhibitorsmentioning

confidence: 99%

Alternative treatment options for periocular basal cell carcinoma: a narrative review

Erikson¹,

Brosig²,

Zimbelmann³

et al. 2022

Front Oral Maxillofac Med

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This literature review presents the latest developments as well as established procedures that offer alternative treatment approaches to basal cell carcinoma (BCC) when micrographically controlled surgical removal is not possible. Micrographically controlled surgical removal remains the gold standard in the treatment of BCC. When surgical removal is impossible, other procedures can be chosen. The alternative treatment options can be divided into three main groups: treatment options for locally advanced or metastasized BCC, topical approaches for small and superficial BCC and prophylactic measures.While radiotherapy and systemic therapy are suitable for locally advanced BCC that are discussed in an interdisciplinary tumor board, small and superficial BCC can be treated by topical therapy. In cases of a previous BCC history, a prophylactic treatment can be considered. A combination of systemic treatment and neoadjuvant or adjuvant approaches before or after surgery are promising options for a successful outcome, which can further improve the standard treatment for locally advanced BCC. However, due to the lack of therapy success controls for both treatment options, almost all forms of therapy are inferior to micrographically controlled surgery and should therefore only be used if there are substantial reasons against R0 resection. In this review a literature search on PUBMED was carried out and a structured display and analysis of the results are given.

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Efficacy of Vismodegib for the Treatment of Orbital and Advanced Periocular Basal Cell Carcinoma

Cited by 33 publications

References 21 publications

Vismodegib for periocular basal cell carcinoma: an international multicentre case series

Vismodegib for periocular basal cell carcinoma: an international multicentre case series

Vismodegib for Preservation of Visual Function in Patients with Advanced Periocular Basal Cell Carcinoma: The VISORB Trial

Alternative treatment options for periocular basal cell carcinoma: a narrative review

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