Treatment of Locally Advanced Basal Cell Carcinoma With Neoadjuvant Vismodegib
Posted: Monday, July 16, 2018
The neoadjuvant administration of the hedgehog pathway inhibitor vismodegib appears to be beneficial in patients with locally advanced basal cell carcinoma by reducing tumor size and facilitating resection. Of the 44 participants who underwent resection after treatment with vismodegib, 27 (61%) had a complete response confirmed by biopsy. The initial results of the phase II study were presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9509).
“Neoadjuvant vismodegib allows a downstaging of surgical procedure for [locally advanced basal cell carcinomas] in functionally sensitive locations,” noted primary investigator Laurent Mortier, MD, of the University Hospital of Lille, France, and colleagues. Participants will continue to be followed to assess the quality of long-term local control.
The open-label, noncomparative trial included 55 patients with at least 1 basal cell carcinoma that was of the face, inoperable, or operable with functional or major aesthetic sequelae risk. Participants received oral vismodegib at 150 mg daily for 4 to 10 months. Treatment continued until the “best response” with vismodegib was observed, at which point surgery was performed.
At the time of enrollment, 4 tumors were inoperable, 15 tumors were operable with a major functional risk, and 36 tumors were operable with a minor functional risk or a major aesthetic risk. After treatment with vismodegib, 80% (n = 44) of patients underwent resection. The most common adverse events were dysgeusia, muscle spasms, alopecia, fatigue, and weight loss. Grade ≥ 3 events were observed in 20% of treated patients.
