Role of Vismodegib in the Management of Advanced Periocular Basal Cell Carcinoma

Cox, Kathleen H.; Margo, Curtis E.

doi:10.1177/107327481602300207

Cited by 15 publications

(15 citation statements)

References 39 publications

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“…For basal cell carcinomas, the hedgehog pathway inhibitor vismodegib has shown good results for locally advanced tumors (26). Some authors have shown that vismodegib can prevent the need for orbital exenteration for periocular tumors (27), with complete response rates up to 67% (28,29), but this evidence is limited by the small number of cases. Targeted immunotherapy also appears to play a role in locally advanced skin cancers, but more robust supporting evidence is still needed (30).…”

Section: ' Discussionmentioning

confidence: 99%

Short-term survival in extensive craniofacial resections

Leite

Alvarenga

Gonçalves

et al. 2021

Clinics

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Craniofacial resection (CFR) procedures for craniofacial tumors with cranial extension are often extensive. Although CFRs may yield good oncological results, there are concerns about high perioperative morbidity and mortality. This study aimed to determine risk factors for perioperative mortality after open CFR in terms of deaths occurring during index hospitalizations. METHODS: We conducted a retrospective analysis of CFRs conducted at a tertiary oncology hospital from May 2009 through December 2018. RESULTS: Our analysis included data from the medical records of 102 patients, the majority of whom were male (n=74, 72.5%). The mean age was 61 years ( ± 18.3 years). Skin malignancies (n=64, 63.4%) accounted for nearly two-thirds of the treated tumors, and most of these were squamous cell carcinoma. Postoperative medical complications occurred in 33 patients (33%), and surgical complications occurred in 48 (47%). Multivariate analysis revealed the only independent risk factors for perioperative deaths to be the presence of intracranial tumor extension on preoperative imaging (hazard ratio [HR]=4.56; 95% confidence interval [CI]: 1.74-11.97; p=0.002) and the unexpected emergence of postoperative neurological dysfunction (HR=10.9; 95% CI: 2.21-54.3; p=0.003). CONCLUSIONS: In our study, factors related to tumor extension were associated with a higher risk of perioperative death.

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Section: ' Discussionmentioning

confidence: 99%

Short-term survival in extensive craniofacial resections

Leite

Alvarenga

Gonçalves

et al. 2021

Clinics

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“…Another review conducted for the periocular treatment with Vismodegib reports a complete regression of 30% of patients, with follow-up less than 5 months. However, further randomized-controlled-trials are needed to investigate whether the use of Vismodegib in periocular BCC has an impact on local tumor control, survival, or quality of life (21). Figures 1,2 show periocular BCC before and after treatment with Vismodegib (22).…”

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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“…The authors documented a significant complete clinical response in 141 of 384 patients (37%) after a mean duration of vismodegib treatment of 36.7 weeks (range: 11-100 weeks) for nonmetastatic patients. 4,[7][8][9][10][11][12][13][14]18,[24][25][26][27] Information concerning the treatment choice was available for 325 patients (84.6%, 325/384) and complete remission was found to be achieved exclusively by medical treatment for 110 patients (33.8%, 110/325), for 20 patients (6.1%, 20/325) by vismodegib followed by surgery, and for 3 patients (0.9%, 3/325) by vismodegib followed by surgery and radiotherapy. For 58 patients treated by an association of vismodegib and radiotherapy, it was not possible to find the overall treatment response.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…In advanced BCC, the Hedgehog signaling pathway inhibitor vismodegib is becoming key treatment and has recently been enhanced by combination with PD-1 inhibitor therapy. [3][4][5] When vismodegib is used as neoadjuvant therapy, the ERIVANCE BCC study showed that it had a response rate of 30% for metastatic BCC and 43% for locally advanced BCC, 3 and for periocular locally advanced BCC, the STEVIE trial study reported complete response rate of 28.9%. The outcomes of patients treated by vismodegib as neoadjuvant therapy are now well documented in response rate or adverse events, but to date, few studies have provided an overview of the functional issues regarding eyelid sclerosis after treatment and the need of complementary resection or local reconstruction.…”

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confidence: 99%