Vismodegib improves quality of life in patients with periocular locally advanced basal cell carcinoma: subgroup analysis, STEVIE trial

Gershoni, Assaf; Tiosano, Alon; Ishai, Meydan Ben; Barayev, Edward; Simon, Guy Ben; Yassur, Iftach

doi:10.1038/s41433-021-01493-2

Cited by 9 publications

(3 citation statements)

References 20 publications

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“…22 In addition, POLA-BCC could cause disfiguring eye conditions and reduce the functioning of patients because of high levels of psychological distress and decreased social interaction. 23 Gershoni et al 23 reported an improvement in health-related quality of life for the functioning, symptoms, and emotions in POLA-BCC patients who received vismodegib treatment compared to the control group.…”

Section: Treatment Outcomesmentioning

confidence: 99%

Review of Targeted Therapy, Vismodegib, for the Treatment of Periocular Basal Cell Carcinoma

Singalavanija,

Ceylanoglu,

Juntipwong

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: Periocular locally advanced basal cell carcinoma (POLA-BCC) is characterized by orbital involvement and/or extensive invasion of periocular structures. Hedgehog pathway inhibitors have been used for POLA-BCC with promising outcomes. Methods: The authors reviewed 11 articles published in English literature from January 2012 to July 2022 and reported the outcomes of patients with POLA-BCC who were treated with vismodegib. Results: A total of 384 patients were treated with vismodegib. The mean age was 72 years, and the median treatment duration was 9 months. The overall response rate was 75% with a median follow-up time of 14.4 months. Following vismodegib treatment, the median number of patients who required adjuvant surgery was 43% with a median time to surgery of 6.5 months. The exenteration rate was 6% (overall 8 patients). In total 93.7% of patients experienced grade I adverse events, 26.7% to 37.5% grade II, 8.8% to 10% grade III–IV, and 0.8% to 4.8% grade V. Major side effects included dysgeusia (30–100%), muscle spasm (15–100%), alopecia (47–75%), weight loss (23–83%), and decreased appetite (19–42%). The median percentage of patients who discontinued treatment due to toxicity was 29% with a median interval of 5 months before the development of side effects. The median recurrence rate following discontinuation of vismodegib was 7.8% with a median recurrence duration of 20 months. Conclusions: In patients with POLA-BCC, vismodegib, a hedgehog pathway inhibitor, provided high rates of orbital preservation, reducing exenteration rates to 6%. Neoadjuvant therapy with vismodegib can also be suggested for patients with POLA-BCC. While extremely effective, side effects lead to temporary or permanent discontinuation of vismodegib in small numbers of patients.

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Section: Treatment Outcomesmentioning

confidence: 99%

Review of Targeted Therapy, Vismodegib, for the Treatment of Periocular Basal Cell Carcinoma

Singalavanija,

Ceylanoglu,

Juntipwong

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…There are more and more studies showing a favorable clinical response in the treatment of BCC with vismodegib, in the periocular region or in any part of the body and of any histological type, even in basosquamous carcinoma [ 15 , 65 , 68 , 69 ]. This also leads to an improvement in the emotional stress caused by the tumor in these patients [ 2 ]. In recent years, its use has been tested in advanced tumors with orbital invasion, in isolated cases or in case series, with a complete response to treatment between 25% and 87.5% [ 6 , 40 , 56 , 66 – 71 ].…”

Section: Discussionmentioning

confidence: 99%

“…Seventy-five per cent of these cancers occur in the head and neck and around 20% in the periocular region [ 1 ]. It is the most common periocular malignant tumor, approximately 90% of cases, and its incidence is gradually increasing [ 2 ]. It usually occurs in older people and with exposure to ultraviolet radiation (UVR).…”

Section: Introductionmentioning

confidence: 99%

Advanced Periocular Basal Cell Carcinoma with Orbital Invasion: Update on Management and Treatment Advances

Bengoa-González,

Mencía-Gutiérrez,

Garrido

et al. 2024

Journal of Ophthalmology

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Purpose. Basal cell carcinoma (BCC) is the most frequent malignant periocular tumor. It is associated with exposure to ultraviolet radiation, and its incidence is gradually increasing. It may occasionally display more aggressive behavior and result in orbital or intracranial invasion. Mortality from periocular BBC with orbital invasion is very low, but the associated morbidity can be significant, from disfigurement to blindness. Traditionally, these cases have been treated with orbital exenteration or with radiotherapy (RT), but in recent years, hedgehog pathway inhibitors (HPIs) have emerged, are effective in more serious cases, and are used primarily or combined with surgery, changing our perspective on the management of these patients. Methods. We studied 24 cases of periocular BCC with orbital invasion, some primary and others recurrent, which were treated between 2011 and 2021 in the same hospital. All patients had clinical or radiological evidence of orbital invasion. Orbital exenteration was performed on 9/24 of the patients (1 received vismodegib after surgery), and 12/24 were treated, surgically preserving the eyeball, with 3 of them receiving adjuvant vismodegib. Three of the twenty-four patients were treated exclusively with vismodegib (Erivedge®, Genentech). Results. One patient died due to poor tumor evolution, but the rest evolved favorably and they have had no recurrences. Vismodegib was generally well tolerated, except for in one patient who discontinued treatment due to the side effects. Conclusions. In advanced BBC with orbital invasion, mutilating surgical treatments such as exenteration or potentially vision-threatening treatments such as RT remain as options. In recent years, however, very promising new medical therapies have emerged, such as HPI, which can be used effectively instead of surgery or in combination with it, preserving the eye and vision, which implies a new approach to treatment.

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Exploring vismodegib: A non-surgical breakthrough in the management of advanced periocular basal cell carcinoma

Lavasidis,

Tzamalis,

Tsinopoulos

et al. 2024

Cancer Treatment and Research Communications

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Vismodegib improves quality of life in patients with periocular locally advanced basal cell carcinoma: subgroup analysis, STEVIE trial

Cited by 9 publications

References 20 publications

Review of Targeted Therapy, Vismodegib, for the Treatment of Periocular Basal Cell Carcinoma

Review of Targeted Therapy, Vismodegib, for the Treatment of Periocular Basal Cell Carcinoma

Advanced Periocular Basal Cell Carcinoma with Orbital Invasion: Update on Management and Treatment Advances

Exploring vismodegib: A non-surgical breakthrough in the management of advanced periocular basal cell carcinoma

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