Ocular preservation with neoadjuvant vismodegib in patients with locally advanced periocular basal cell carcinoma

Sagiv, Oded; Nagarajan, Priyadharsini; Ferrarotto, Renata; Kandl, Thomas J.; Thakar, Sudip D.; Glisson, Bonnie S.; Altan, Mehmet; Esmaeli, Bita

doi:10.1136/bjophthalmol-2018-312277

Cited by 42 publications

(76 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The interventions were successful with disease-free margins, and the patients are currently in follow-up without disease recurrence. A neoadjuvant approach with HPIs has already been reported previously 16,17,18 . In this setting, the use of sonidegib may be of interest since AEs seem to appear slightly later than with vismodegib 6 .…”

Section: Discussionmentioning

confidence: 95%

Treatment of periocular advanced basal cell carcinoma with Hedgehog pathway inhibitors: a single-center study and a new dedicated therapeutic protocol

et al. 2021

View full text Add to dashboard Cite

Background: The management of difficult-to-treat periocular basal cell carcinoma becomes very challenging in cases of delayed diagnosis, leading to the development of locally advanced basal cell carcinoma.Objective: The aim of this study was to evaluate the outcomes of Hedgehog pathway inhibitors (vismodegib and sonidegib) treatment in patients affected by periocular locally advanced basal cell carcinoma. We focused on the common adverse events and their correlation with the administration schedule in order to determine a management protocol specific for the periocular area.Methods: This observational prospective study included a single-center case series with patients who were histologically confirmed to have periocular or orbital locally advanced basal cell carcinoma, treated with Hedgehog pathway inhibitors.Results: All patients benefitted in terms of regression or stabilization of the neoplasm. In the first months of treatment, the HPIs were well tolerated, and the first important side effects appeared after about 5 months of continuous use of the drug.Conclusion: These data could lead to a new type of therapeutic scheme where neoadjuvant therapy could be followed by pulse therapy as an adjuvant to surgery.

show abstract

Section: Discussionmentioning

confidence: 95%

Treatment of periocular advanced basal cell carcinoma with Hedgehog pathway inhibitors: a single-center study and a new dedicated therapeutic protocol

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The pivotal study, a prospective nonrandomized clinical trial, revealed a 43% response rate among patients with locally advanced BCC and 30% response rate among patients with metastatic BCC, with a median duration of response of 7.6 months [ 8 ]. Prospective trials have assessed vismodegib as a neoadjuvant in a variety of body locations [ 17 , 18 , 19 ], and several case studies have highlighted the efficacy of vismodegib for preserving vision in patients with orbital BCC [ 20 , 21 , 22 , 23 , 24 , 25 ]. More recently, post hoc prospective analysis of the multisite multicountry Safety Events in Vismodegib study data showed either complete or partial response to vismodegib in 67% of patients [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Vismodegib for Preservation of Visual Function in Patients with Advanced Periocular Basal Cell Carcinoma: The VISORB Trial

et al. 2021

View full text Add to dashboard Cite

show abstract

“…This could be explained by the lack of clear guidelines for the definition of remission. Several studies were based on a clinical examination (mainly based on the RECIST criteria [ 15 , 17 ]), whereas other studies were based on a systematic surgical biopsy [ 16 ]. Of course, the histological analysis remains the gold standard, and the benefit/risk ratio and economic balance should be carefully considered for each patient.…”

Section: Second Step Towards Eye-sparing Strategies: Use Of Targeted Therapies and Immunotherapiesmentioning

confidence: 99%

New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm?

Martel

Lassalle

Picard‐Gauci

et al. 2021

Cancers

View full text Add to dashboard Cite

The management of periocular skin malignant tumours is challenging. Surgery remains the mainstay of treatment for localised eyelid cancers. For more locally advanced cancers, especially those invading the orbit, orbital exenteration has long been considered the gold standard; however, it is a highly disfiguring and traumatic surgery. The last two decades have been marked by the emergence of a new paradigm shift towards the use of ‘eye-sparing’ strategies. In the early 2000s, the first step consisted of performing wide conservative eyelid and orbital excisions. Multiple flaps and grafts were needed, as well as adjuvant radiotherapy in selected cases. Although being incredibly attractive, several limitations such as the inability to treat the more posteriorly located orbital lesions, as well as unbearable diplopia, eye pain and even secondary eye loss were identified. Therefore, surgeons should distinguish ‘eye-sparing’ from ‘sight-sparing’ strategies. The second step emerged over the last decade and was based on the development of targeted therapies and immunotherapies. Their advantages include their potential ability to treat almost all tumours, regardless of their locations, without performing complex surgeries. However, several limitations have been reported, including their side effects, the appearance of primary or secondary resistances, their price and the lack of consensus on treatment regimen and exact duration. The aim of this article was to review the evolution of the management of locally advanced periocular malignant tumours over the last three decades and highlight the new paradigm shift towards the use of ‘eye-sparing’ strategies.

show abstract

Ocular preservation with neoadjuvant vismodegib in patients with locally advanced periocular basal cell carcinoma

Cited by 42 publications

References 20 publications

Treatment of periocular advanced basal cell carcinoma with Hedgehog pathway inhibitors: a single-center study and a new dedicated therapeutic protocol

Treatment of periocular advanced basal cell carcinoma with Hedgehog pathway inhibitors: a single-center study and a new dedicated therapeutic protocol

Vismodegib for Preservation of Visual Function in Patients with Advanced Periocular Basal Cell Carcinoma: The VISORB Trial

New Targeted Therapies and Immunotherapies for Locally Advanced Periocular Malignant Tumours: Towards a New ‘Eye-Sparing’ Paradigm?

Contact Info

Product

Resources

About