The use of vismodegib in the treatment of basal cell carcinoma based on case reports

Abstract

Basal cell carcinoma (BCC) is the most common skin cancer, usually located on the skin of the face and neck. Locally advanced cancer is diagnosed by about 5–10% of patients, while the metastatic disease is diagnosed in 0.0028 to 0.55% of cases. The primary treatment of locally advanced disease is radical surgery, and in non-operative cases — radiotherapy. For patients not eligible for local therapy and those with metastatic disease, systemic therapies, including hedgehog inhibitor — vismodegib — is used. In the Department of Melanoma and Soft Tissue and Bone Sarcomas, Maria Sklodowska-Curie Institute — Oncology Center several patients with BCC, not eligible for local therapy, are currently systemically treated. Vismodegib is registered for the use in adults with symptomatic metastatic basal cell carcinoma or locally advanced basal cell carcinoma that does not meet the criteria for surgical treatment or radiotherapy. In this paper, we present and discuss a case of BCC cancer in a metastatic setting and a case of a patient being treated for locally advanced disease not eligible for surgery and radiotherapy. The cases presented here confirm that vismodegib treatment, currently available in the national drug access program, provides an objective response, improvement in quality of life, and probably extension of survival.