Vismodegib for giant, locally advanced, basal cell carcinoma and its complex position in clinical practice

Koekelkoren, Fabiënne H. J.; Roodbergen, Sofie L.; Baerveldt, Ewout M.; Maat, Alexander P.W.M.; Monserez, Dominiek; Grünhagen, Dirk J.; Mureau, Marc A.M.; Haas, E; Nijsten, Tamar; Wakkee, Marlies

doi:10.1016/j.jdcr.2018.11.002

Cited by 6 publications

(8 citation statements)

References 6 publications

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“…Recently, a case series suggested that vismodegib could be less effective in deep tumor planes involving bone or cartilage. The potential role of suboptimal blood perfusion resulting in lower vismodegib tissue levels was supposed [13]. Indeed, vismodegib has a low tissue distribution volume (from 16.4 to 26.6 L).…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Non-Response to Vismodegib in Locally Advanced Basal-Cell Carcinoma

et al. 2021

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Background: Vismodegib has shown clinical efficacy in the management of locally advanced basal cell carcinomas (laBCC). However, non-response to vismodegib is observed in 2–13.5% of patients in clinical studies. The purpose of this study was to identify factors associated with non-response to vismodegib in patients with laBCC. Methods: We carried out a retrospective multicenter study, including patients with laBCC treated with vismodegib, from July 2011 to May 2019. Response to treatment was assessed according to the RECIST 1.1 criteria. Patients were categorized as responders with a complete response or a partial response or non-responders with a stable disease or a progressive disease according to what has been observed during follow-up. Patient demographics, tumor profile, and treatment modalities were compared in responders and non-responders. Results: Eighty-three patients with laBCC were included in the study. Twenty-five (30.1%) were non-responders to vismodegib. History of treatment with radiotherapy, presence of muscle involvement and intermittent treatment with vismodegib were significantly associated with a non-response (p < 0.001, p = 0.025, p < 0.001). Bone involvement (p = 0.2) and morpheaform IaBCC subtype (p = 0.056) were more frequent in non-responders without reaching statistical significance. Conclusion: In this study, non-response of laBCC to vismodegib therapy was associated with muscle involvement. Previous radiotherapy and intermittent use of vismodegib have been identified as causes favoring non-response to vismodegib. Due to the low numbers of patients included in the study, it is difficult to draw firm conclusions. Further studies are needed to confirm these data.

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Section: Discussionmentioning

confidence: 99%

Predictive Factors of Non-Response to Vismodegib in Locally Advanced Basal-Cell Carcinoma

et al. 2021

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“…However, objective treatment criteria or strong evidence-based medicine recommendations were lacked until now. The popular smoothened inhibitor, Vismodegib, was also limited by its obvious adverse effects [ 19 , 20 ]. These facts made the further biological understanding of aBCC is still greatly needed.…”

Section: Discussionmentioning

confidence: 99%

p75NTR/proBDNF Modulates Basal Cell Carcinoma (BCC) Immune Microenvironment via Necroptosis Signaling Pathway

Yuan

et al. 2021

Journal of Immunology Research

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Basal cell carcinoma (BCC) is the most common skin cancer. While most of the basal cell carcinomas were localized lesion and can be easily managed, the treatment options to the advanced basal cell carcinomas are still remarkably limited. In recent years, proBDNF and its receptor p75NTR have been reported to play important roles in various diseases, including cancers and psychotic disorders. However, the role of p75NTR/proBDNF signaling in basal cell carcinoma remains unclear. Here, we found that the expression level of p75NTR/proBDNF was decreased in basal cell carcinoma patient samples and cell lines. In vitro study showed overexpression of p75NTR/proBDNF could significantly facilitate tumor cell death, including inflammatory-silent apoptosis and lytic inflammatory activated necroptosis. In vivo study showed overexpression of p75NTR/proBDNF dramatically promotes tumor-associated macrophage (M1) and T cell recruitment in a syngeneic mouse model of BCC. These results show a crucial role for p75NTR/proBDNF signaling in basal cell carcinoma immune microenvironment.

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“…17 However, another study documented that although there may be reduction in the cutaneous lesion of the giant BCC, there was no reduction in the deeper tumor plane, and the patient still required adequate deep margins. 18 Furthermore, usage of this drug may be challenging secondary to tumor resistance, the side effect profile, and recurrence after cessation of the drug. [18][19][20] Other considerations must be taken into account when prescribing hedgehog inhibitors, including patient compliance.…”

Section: Discussionmentioning

confidence: 99%

“…18 Furthermore, usage of this drug may be challenging secondary to tumor resistance, the side effect profile, and recurrence after cessation of the drug. [18][19][20] Other considerations must be taken into account when prescribing hedgehog inhibitors, including patient compliance. Monitoring a patient's response to treatment is essential in the case of a giant BCC.…”

Section: Discussionmentioning

confidence: 99%

“…Monitoring a patient's response to treatment is essential in the case of a giant BCC. 18 A patient who is at risk for non-compliance, such as those with giant BCCs, may not be ideal candidates for this intervention. The patient in this case had difficulty obtaining insurance and was lost to follow-up after surgical intervention; therefore, no additional treatments were performed.…”

Section: Discussionmentioning

confidence: 99%

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A lobulated mass on the upper back with prominent vasculature: A giant basal cell carcinoma

et al. 2021

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Basal cell carcinoma (BCC) is characterized by slow but locally invasive growth. Although there is low metastatic potential, if not treated early, these skin cancers can lead to significant morbidity and mortality. In this case report, we present a man with a neglected BCC that developed into what is termed a giant BCC or one that is greater than 5 cm. This tumor was discovered only upon workup of orthostatic lightheadedness and iron deficiency anemia. Although rare, basal cell carcinoma must be included on the differential of a large cutaneous lesion and may be a source of significant blood loss.

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Vismodegib for giant, locally advanced, basal cell carcinoma and its complex position in clinical practice

Cited by 6 publications

References 6 publications

Predictive Factors of Non-Response to Vismodegib in Locally Advanced Basal-Cell Carcinoma

Predictive Factors of Non-Response to Vismodegib in Locally Advanced Basal-Cell Carcinoma

p75NTR/proBDNF Modulates Basal Cell Carcinoma (BCC) Immune Microenvironment via Necroptosis Signaling Pathway

A lobulated mass on the upper back with prominent vasculature: A giant basal cell carcinoma

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