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Role of Vismodegib in the Management of Advanced Periocular Basal Cell Carcinoma
1Department of Ophthalmology, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA. kfcox2@health.usf.edu.
Background:
Vismodegib is the first selective hedgehog pathway inhibitor approved to treat locally advanced and metastatic basal cell carcinoma (BCC). Limited information is available concerning its role in managing advanced BCC around the eye.
Methods:
The medical literature was searched for cases of nonsyndromic periocular BCC treated with vismodegib. Clinical information was abstracted and analyzed. In addition, a review of the pharmacology of vismodegib, including general effectiveness and safety, was conducted.
Results:
Thirty study patients with nonsyndromic periocular BCC treated with vismodegib were found in the literature. Vismodegib was used in 3 ways: medical therapy, adjuvant therapy prior to surgery or radiotherapy, and treatment of positive surgical margins. Complete regression was reported in 9 study patients (30%), with follow-up visits after therapy averaging fewer than 5 months. Four study participants developed squamous cell carcinoma while receiving treatment.
Conclusions:
Too few cases exist to draw any conclusions on the role that vismodegib might play in the management of periocular BCC. In addition, long-term follow-up data are not yet available. Although the objective response rate of advanced BCC is impressive in study patients receiving vismodegib, well-controlled clinical studies are needed to determine whether vismodegib has any impact on survival or quality of life.
Insights
Vismodegib shows potential for advanced periocular basal cell carcinoma (BCC), but limited data and short follow-up prevent definitive conclusions on its effectiveness and long-term impact.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Vismodegib is a hedgehog pathway inhibitor for advanced basal cell carcinoma (BCC).
- Limited data exists on vismodegib's use for periocular BCC.
Purpose of the Study:
- To review the role of vismodegib in managing advanced periocular BCC.
- To analyze existing case studies on vismodegib treatment for this condition.
Main Methods:
- Literature search for periocular BCC cases treated with vismodegib.
- Abstraction and analysis of clinical information.
- Review of vismodegib pharmacology, efficacy, and safety.
Main Results:
- 30 cases of periocular BCC treated with vismodegib were identified.
- Vismodegib was used as medical therapy, neoadjuvant/adjuvant therapy, or for positive margins.
- Complete regression occurred in 30% of patients, with a median follow-up under 5 months.
- Four patients developed secondary squamous cell carcinoma.
Conclusions:
- Insufficient evidence exists to conclude vismodegib's role in periocular BCC management.
- Long-term follow-up data is lacking.
- Further controlled studies are needed to assess vismodegib's impact on survival and quality of life.
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