ASCO20: Preserving Eye Function in Locally Advanced Orbital/Periocular Basal Cell Carcinoma
Posted: Tuesday, June 2, 2020
Visual function and organ preservation were achieved in patients with locally advanced orbital or periocular basal cell carcinoma when treated with vismodegib in the neoadjuvant setting. Francis P. Worden, MD, of the University of Michigan, Ann Arbor, and colleagues presented these findings in a poster session during the ASCO20 Virtual Scientific Program (Abstract 10069).
“Vismodegib is practice-changing as neoadjuvant therapy for locally advanced basal cell carcinoma of the eye/lacrimal drainage system in which surgery would result in unacceptable morbidity,” concluded the authors.
There were 34 patients enrolled in this study who had globe and lacrimal-threatening orbital/periocular basal cell carcinoma. Patients received 150 mg of vismodegib for an average of 223 days and were evaluated by ophthalmic exam every 3 months, with imaging at 5 to 9 months. Patients were assessed for eye function using the Visual Assessment Weight Score (VAWS), with a score of 21 of 50 representing preservation of the eye.
In total, 27 patients (77%) underwent surgery, and 33 (97%) attained organ preservation. The overall response rate by ophthalmic exam was 84%, with 54% of patients achieving a complete response and 29% achieving a partial response. The overall response rate according to imaging was 72%, with 46% of patients achieving a complete response and 26% achieving a partial response. The mean VAWS at baseline was 44 of 50, improving to 46 of 50 at 3 months, and 47 of 50 at the final post-treatment assessment.
The 27 patients who underwent surgery had their specimens evaluated for histologic response. No evidence of disease was seen in 67% of patients; 22% had clear margins and 11% had basal cell carcinoma at the margin. Two patients had recurrence of disease and underwent Mohs surgery. No patients reported a grade 3 or higher adverse event throughout the course of the study.
Disclosure: For full authors’ disclosures, visit coi.asco.org.
