Treatment of basal cell carcinoma with vismodegib: future or present?

Abstract

BACKGROUND:

Since the introduction of Vismodegib as treatment of recurrent locally advanced basal cell carcinoma (laBCC), clinicians are faced with new dilemmas: 'Can Vismodegib replace complex reconstructions?', 'What is the role of neoadjuvant use of Vismodegib?' and 'What is the best approach in case of complete clinical remission after Vismodegib in a neoadjuvant setting?'

METHODS:

Case report and literature review.

RESULTS:

Case report Complete dermoscopic remission after eight months Vismodegib was obtained in a patient with recurrent laBCC. Follow-up was 12 months. Literature review: Vismodegib shows histologic clearance in 42% of patients with operable basal cell carcinoma. Recurrence after neoadjuvant use of Vismodegib in laBCC was described. Moreover, histology revealed residual tumour cells in cases of complete clinical remission after 6 months Vismodegib.

CONCLUSIONS:

Vismodegib cannot replace complex reconstructions. However, in unresectable laBCC, Vismodegib can provide a bridge to surgery. Due to the possibility of persistent tumour cells, we recommend imaging-assisted surgery and an imaging-based follow-up. In case of complete clinical remission after Vismodegib in a neoadjuvant setting, we recommend that Vismodegib be continued as long as the adverse effects are tolerated and an imaging-based follow-up is advised.

• Authors: Jos Velleman, Outi Kaarela, Jan J Vranckx
• Journal: Acta chirurgica Belgica (Acta Chir Belg) Vol. 121 Issue 3 Pg. 198-203 (Jun 2021) ISSN: 0001-5458 [Print] England
• PMID: 31437079 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anilides
• Antineoplastic Agents
• HhAntag691
• Pyridines

Topics

• Anilides
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Basal Cell (drug therapy)
• Humans
• Neoplasm Recurrence, Local
• Pyridines
• Skin Neoplasms (drug therapy)