Vismodegib as Eye-Sparing Adjuvant Treatment for Orbital Basal Cell Carcinoma

Abstract

If these lesions were at the level of the RPE, one would expect them to be visualized on FAF imaging. However, they were completely silent on FAF imaging, suggesting that they may be located deeper than the RPE, at the level of the choriocapillaris. We distinguished 3 types of lesions based on their multimodal imaging characteristics in APMPPE. Type 1 lesions seem to be located at the level of the choriocapillaris and are transient. Type 2 and 3 lesions are at the level of the RPE and are permanent.The pigmented lesions were distributed along the choroidal vasculature on AO imaging (Figure 2). They may correspond to pigment-laden macrophages or accumulation of pigment granules and may indicate a secondary reaction at the level of the RPE induced by an inflammatory process at the level of the choroidal vasculature. Their size and shape were not consistent with RPE cells.Acute posterior multifocal placoid pigment epitheliopathy is characterized by prominent RPE changes, but the permanent RPE damage (type 2 and 3 lesions) may be secondary to an acute transient choroidal inflammatory process (type 1 lesions).

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

“…The authors stated that vismodegib was not effective in patients who received it for less than 3 months. Kahana et al reported in a letter to the editor of a single patient with an orbital BCC 10 years after initial excision who was treated with oral vismodegib for 4 months with a partial response and about 70% reduction in tumour size 12. The patient stopped treatment due to intolerable muscle spasms and surgery was carried out with globe-preservation.…”

Treatment of Advanced Basal Cell Carcinoma with Sonidegib: Perspective from the 30-Month Update of the BOLT Trial

“…All three cohorts did not meet the primary efficacy end points, predefined as CHC >50% in cohorts 1 (received vismodegib for 12 weeks before MMS) and 3 (received vismodegib for 8 weeks on/4 weeks off/8 weeks on before MMS) and CHC >30% in cohort 2 (received vismodegib for 12 weeks followed by 24 weeks of observation before MMS). Although other smaller studies have shown tumor size reduction with vismodegib therapy, convincing data from larger trials supporting the neoadjuvant use of HPIs is currently lacking [51][52][53].…”

Efficacy of Vismodegib (Erivedge) for Basal Cell Carcinoma Involving the Orbit and Periocular Area

“…5 In the periocular and orbital area, vismodegib has been used as a medical or adjuvant therapy to decrease the tumor size, in the latter case to render it amenable to globe-sparing excision. 6–8 In this report, we analyze our results in using vismodegib for the treatment of basal cell carcinoma with orbital extension and/or extensive periocular involvement.…”