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Intermittent Treatment With Vismodegib in Basal Cell Carcinoma: Pilot Study

By: Joseph Fanelli
Posted: Tuesday, February 16, 2021

For patients with basal cell carcinoma, treatment with vismodegib utilizing an intermittent schedule may improve the duration of treatment to allow for a long-term treatment response, according to findings of a pilot study presented in Frontiers in Oncology. Armando Santoro, MD, PhD, of the Humanitas Clinical and Research Center, Rozzano, Italy, and colleagues noted that intermittent treatment with this oral inhibitor of the Hedgehog pathway is viable even in elderly or frail patients.

“Based on these preliminary findings, dedicated studies may be planned to further evaluate an intermittent schedule of vismodegib administration,” the authors concluded.

In this retrospective study, the authors analyzed the clinical charts of 17 patients with multiple or locally advanced basal cell carcinoma treated with vismodegib. Patients first received 150 mg of vismodegib per day, continuously, followed by a rescheduled dosage of 150 mg for 4 weeks. A subsequent 2-week stop was then allowed, according to the standard practice of the authors’ institution.

After 2 months of treatment, all patients achieved disease control, with seven reporting a complete response, six having a partial response, and four with stable disease. However, two patients did experience disease progression soon after the first assessment, and one patient had treatment interrupted after 6 months.

The authors found that 14 patients with responsive disease had an adverse event that required a change in the treatment plan. All of those patients experienced cramps, and 20% had dysgeusia. Of the 17 patients analyzed, it was possible to reschedule treatment by postponing the therapy for 2 weeks after every 4-week cycle in nearly half of them. At the end of the analysis, these patients were all still alive with a complete response. All adverse events were resolved during the first interruption of therapy.

Disclosure: The authors reported no conflicts of interest.

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