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Effective anti-programmed death-1 therapy in a SUFU-mutated patient with Gorlin-Goltz syndrome
A Moreira1, M C Kirchberger1, F Toussaint1
1Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), 91054, Erlangen, Germany.
Abstract:
We present the case of a 77-year-old male patient with more than 50 basal cell carcinomas on the head and upper trunk. The patient did not respond to several lines of treatment, including surgery, imiquimod, retinoids, itraconazole and therapy with the hedgehog inhibitor vismodegib. The patient responded well to off-label therapy with the anti-programmed death-1 antibody pembrolizumab after four infusions.
Insights
A patient with over 50 basal cell carcinomas, resistant to multiple treatments, showed significant improvement with the immunotherapy drug pembrolizumab. This anti-programmed death-1 antibody offered a new therapeutic option for advanced basal cell carcinoma.
Area of Science:
- Oncology
- Dermatology
- Immunotherapy
Background:
- Basal cell carcinoma (BCC) is the most common human cancer.
- Advanced BCC can be challenging to treat, especially when resistant to standard therapies.
- The patient presented with numerous, treatment-refractory basal cell carcinomas.
Observation:
- A 77-year-old male presented with over 50 basal cell carcinomas on the head and upper trunk.
- The patient exhibited resistance to multiple treatment modalities, including surgery, imiquimod, retinoids, itraconazole, and vismodegib.
Findings:
- Off-label administration of the anti-programmed death-1 antibody, pembrolizumab, was initiated.
- Significant positive response was observed after four infusions of pembrolizumab.
- Pembrolizumab demonstrated efficacy in a treatment-refractory case of extensive basal cell carcinoma.
Implications:
- Pembrolizumab represents a potential novel therapeutic strategy for advanced and treatment-resistant basal cell carcinoma.
- Immunotherapy targeting the PD-1 pathway may overcome resistance mechanisms seen with other treatments.
- Further investigation into pembrolizumab's role in managing advanced BCC is warranted.
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