Vismodegib treatment in a HIV positive patient on antiretroviral therapy

Scalvenzi, Massimiliano; Villani, Alessia; Mazzella, Caterina; Cappello, Milena; Salvatores, Gaia De Fata; Costa, Cláudia

doi:10.4103/ijdvl.ijdvl_92_18

Cited by 27 publications

(11 citation statements)

References 5 publications

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“…Basal cell carcinoma (BCC) is the most common NMSC. Although surgery is the first-line therapy for BCC, some cases can progress to an advanced or—very rarely—a metastatic state, frequently requiring nonsurgical approaches such as cryotherapy, adjuvant radiotherapy, and targeted therapy [4]. Vismodegib is a Hedgehog pathway inhibitor therapy for patients who are affected by locally advanced BCC or metastatic BCC and who are ineligible for surgery and/or radiotherapy [5].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Efficacy of Vismodegib After its Withdrawal and Patients’ Health-Related Quality of Life Using the Dermatology Life Quality Index (DLQI)

Villani

Megna

Fabbrocini

et al. 2019

Dermatol Ther (Heidelb)

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IntroductionAlthough non-melanoma skin cancers (NMSCs) are associated with a very low mortality risk, they have been reported to have a major impact on patients’ health-related quality of life (HRQoL). Vismodegib is a therapy for patients who are affected by locally advanced basal cell carcinoma (BCC) or metastatic BCC who are ineligible for surgery and/or radiotherapy. The aim of the present clinical study was to assess the long-term efficacy of vismodegib after its withdrawal by evaluating the recurrence rate of advanced BCC, assessing also patients’ HRQoL after 3 and 6 months from drug withdrawal.MethodsA retrospective study was performed to analyze patients with advanced and/or multiple BCCs that had been treated with vismodegib (150 mg daily) at the Non-Melanoma Skin Cancer Unit of the University of Naples Federico II (Italy) and had obtained a complete regression in 6 months. At the end of the 6-month treatment cycle, patients that reported total remission of the skin tumor were visited monthly in order to assess their therapeutic response. Moreover, to assess the specific impact of vismodegib on HRQoL, DLQI was administered before vismodegib treatment (baseline), at the end of the therapy cycle (6 months), as well as after 3 and 6 months from vismodegib discontinuation.ResultsThirty-five patients (27 male, 8 female), with a complete regression of their advanced BCC after vismodegib treatment, were included in the study. The duration of treatment for all patients was 6 months as set by study inclusion criteria. A BCC recurrence rate of 31% (11/35) was reported after a 6-month follow-up. The average reported Dermatology Life Quality Index (DLQI) score increased from a value of 0 at the end of the 6-month vismodegib treatment to a mean value of 2.4 after 3 months from drug withdrawal and 3.6 after 6 months from treatment discontinuation.ConclusionThe results of this exploratory analysis of vismodegib withdrawal are consistent with a substantial link between treatment response and patients’ HRQoL. Furthermore, 11 out of 35 (31%) patients that reported a complete remission of the disease after 6 months of vismodegib treatment reported BCC recurrence. These data highlight the importance of continuous follow-up and perhaps different regimens of treatment, such as an alternate dose regimen to maintain disease control and reduce the adverse events as previously described in the literature.

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Section: Introductionmentioning

confidence: 99%

Long-Term Efficacy of Vismodegib After its Withdrawal and Patients’ Health-Related Quality of Life Using the Dermatology Life Quality Index (DLQI)

Villani

Megna

Fabbrocini

et al. 2019

Dermatol Ther (Heidelb)

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with antiretroviral therapy for HIV infection has been described only once in a patient who received vismodegib together with emtricitabine, rilpivirine and tenofovir [12]. Our case is the first report on successful treatment with sonidegib in co-medication with antiretroviral triple therapy.

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mentioning

confidence: 74%

Sonidegib in a patient with multiple basal cell carcinomas and HIV infection

Hoffmann

Husak²,

Maiwirth³

et al. 2021

J Deutsche Derma Gesell

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“…In about 6 months of therapy the patient obtained a complete resolution, after which Vismodegib was discontinued. The article reports good tolerance and no interactions between Vismodegib and the previous cART (132). Reports on SHH inhibitors in immunocompromised patients witch locally advanced or metastasizing BCC are rare (133).…”

Section: Target Therapy In Plwhmentioning

confidence: 93%

“…Reports on SHH inhibitors in immunocompromised patients witch locally advanced or metastasizing BCC are rare (133). Effectual use of Vismodegib and the lack of drug to drug interaction with cART (tenofovir/emtricitabine/rilpivirine) has been described in a single case (132). Recently, Hoffmann V. et al have described a successful case of treatment with Sonidegib in a patient on cART.…”

Section: Target Therapy In Plwhmentioning

confidence: 99%

Non-Melanoma Skin Cancer in People Living With HIV: From Epidemiology to Clinical Management

Rullo

Maimone

Fiorica³

et al. 2021

Front. Oncol.

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Skin cancers represent the most common human tumors with a worldwide increasing incidence. They can be divided into melanoma and non-melanoma skin cancers (NMSCs). NMSCs include mainly squamous cell (SCC) and basal cell carcinoma (BCC) with the latest representing the 80% of the diagnosed NMSCs. The pathogenesis of NMSCs is clearly multifactorial. A growing body of literature underlies a crucial correlation between skin cancer, chronic inflammation and immunodeficiency. Intensity and duration of immunodeficiency plays an important role. In immunocompromised patients the incidence of more malignant forms or the development of multiple tumors seems to be higher than among immunocompetent patients. With regards to people living with HIV (PLWH), since the advent of combined antiretroviral therapy (cART), the incidence of non-AIDS-defining cancers (NADCs), such as NMSCs, have been increasing and now these neoplasms represent a leading cause of illness in this particular population. PLWH with NMSCs tend to be younger, to have a higher risk of local recurrence and to have an overall poorer outcome. NMSCs show an indolent clinical course if diagnosed and treated in an early stage. BCC rarely metastasizes, while SCC presents a 4% annual incidence of metastasis. Nevertheless, metastatic forms lead to poor patient outcome. NMSCs are often treated with full thickness treatments (surgical excision, Mohs micro-graphic surgery and radiotherapy) or superficial ablative techniques (such as cryotherapy, electrodesiccation and curettage). Advances in genetic landscape understanding of NMSCs have favored the establishment of novel therapeutic strategies. Concerning the therapeutic evaluation of PLWH, it’s mandatory to evaluate the risk of interactions between cART and other treatments, particularly antiblastic chemotherapy, targeted therapy and immunotherapy. Development of further treatment options for NMSCs in PLWH seems needed. We reviewed the literature after searching for clinical trials, case series, clinical cases and available databases in Embase and Pubmed. We review the incidence of NMSCs among PLWH, focusing our attention on any differences in clinicopathological features of BCC and SCC between PLWH and HIV negative persons, as well as on any differences in efficacy and safety of treatments and response to immunomodulators and finally on any differences in rates of metastatic disease and outcomes.

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Vismodegib treatment in a HIV positive patient on antiretroviral therapy

Cited by 27 publications

References 5 publications

Long-Term Efficacy of Vismodegib After its Withdrawal and Patients’ Health-Related Quality of Life Using the Dermatology Life Quality Index (DLQI)

Long-Term Efficacy of Vismodegib After its Withdrawal and Patients’ Health-Related Quality of Life Using the Dermatology Life Quality Index (DLQI)

Sonidegib in a patient with multiple basal cell carcinomas and HIV infection

Non-Melanoma Skin Cancer in People Living With HIV: From Epidemiology to Clinical Management

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