Vismodegib persistence and discontinuation patterns in Greek patients from a real world setting

Abstract

Hedghehog pathway inhibitors have been successfully used for patients with locally advanced basal cell carcinomas. However, these treatments have been associated with various adverse events that may limit patient compliance. In this study, an association of patient and disease characteristics with drug compliance in a real clinical setting was made. 18 patients were included in the study. The average patient age was 78.39 years. The time that patients remained to treatment was, on average, 8.73 months. 72.2% of patients experienced at least one adverse event. At study cut-off, 11 out of 18 patients had discontinued treatment. The most common reason for discontinuation was reported "fatigue" from the treatment due to the type of AEs experienced (37.4%) and patient's choice after complete response achievement (30.8%). Factors that were associated with treatment discontinuation was: number of previous treatments, severity of AEs and patient age.

Adherence to treatment in dermatology: Literature review

“…Regarding oral acne medication, isotretinoin commonly causes skin dryness and erythema, which often limits adherence 47 . In a study of 18 patients with advanced basal cell carcinomas, treatment fatigue due to adverse events, including muscle cramps, alopecia and dysgeusia, was the most common cause of discontinuation of vismodegib 48 . Among psoriasis patients, lack of adherence to tumour necrosis factor‐α (TNF‐α) drugs is mainly due to loss of response over time and adverse events, including infusion reactions 49,50 …”

“…47 In a study of 18 patients with advanced basal cell carcinomas, treatment fatigue due to adverse events, including muscle cramps, alopecia and dysgeusia, was the most common cause of discontinuation of vismodegib. 48 Among psoriasis patients, lack of adherence to tumour necrosis factor-α (TNF-α) drugs is mainly due to loss of response over time and adverse events, including infusion reactions. 49,50 Disease-centred factors Depending on the type, duration, severity, location and psychologic and social burden of skin diseases, adherence to dermatological treatments and recommendations can vary.…”

Tailored Toxicity-Driven Administration of Vismodegib in Patients With Multiple or Locally Advanced Basal Cell Carcinoma: A Pilot Analysis

“…Vismodegib is an oral inhibitor of hedgehog pathway, approved for locally advanced and metastatic BCC in patients who are not amenable to surgery or radiation (5)(6)(7)(8)(9). Some fieldpractice experiences have evaluated the use of vismodegib for the treatment of BCC in daily practice (10)(11)(12)(13)(14)(15). However, the description of a further series of patients will help towards a more comprehensive evaluation of this treatment.…”