Managing adverse events associated with vismodegib in the treatment of basal cell carcinoma

Area of Science:

• Oncology
• Dermatology

Background:

• Basal cell carcinoma (BCC) is the most prevalent skin malignancy.
• Advanced BCC cases often resist standard treatments.
• The hedgehog signaling pathway is crucial in BCC development, with dysregulation observed in 90% of cases.

Framework:

• Vismodegib, a novel oral hedgehog pathway inhibitor, shows efficacy in advanced BCC.
• Expert panel convened to establish management strategies for vismodegib's adverse events.

Implementation:

• Common adverse events include taste disturbances, muscle cramps, and alopecia.
• Key management strategies involve patient expectation setting and therapeutic interruptions.
• Specific interventions include quinine for muscle cramps and dietary modifications for taste disturbances.

Implications:

• Effective management of adverse events is crucial for maintaining optimal vismodegib treatment duration.
• This approach can improve patient outcomes in advanced basal cell carcinoma.
• Expert consensus provides a framework for managing vismodegib-associated toxicities.