Vol 15, No 3 (2019)
Research paper
Published online: 2019-06-26

open access

Page views 1204
Article views/downloads 658
Get Citation

Connect on Social Media

Connect on Social Media

Vismodegib in the treatment of basal cell carcinoma — Polish clinical experience in the frame of therapeutic program

Monika Słowińska1, Aldona Maciąg1, Monika Dudzisz-Śledź2, Izabela Łasińska3, Tomasz Świtaj2, Hanna Koseła-Paterczyk2, Aleksandra Bolewska1, Katarzyna Wróbel1, Paweł Golusiński456, Jacek Mackiewicz378, Piotr Rutkowski2, Witold Owczarek1
Oncol Clin Pract 2019;15(3):139-149.

Abstract

Introduction. Vismodegib is a small-molecule inhibitor of the sonic hedgehog pathway, registered for the treat- ment of patients with metastatic or locally advanced basal cell carcinoma, who were disqualified from surgical excision or radiotherapy. The full treatment refund from the National Health Fund has been available in Poland since 1st January 2018. The aim of the study was to analyse the frequency of occurrence of adverse events based on CTCAE and the treatment results based on the RECIST 1.1 criteria, in a group of patients treated for six or 12 months with vismodegib. 

Material and methods. The patient database was gathered from three sites and consisted of 42 patients, who represented 53.8% of the patients treated with vismodegib in Poland. The duration of the treatment ranged between three weeks and 68 months. The median of the treatment period was 8.25 months (0.75–68); the median of the observation of patients treated for less than 12 months was eight months (6–11), and for those treated for more than 12 months it was 14 months (12–68). 

Results. The summary of the treatment results after six and 12 months was performed on 29/42 and 17/42 patients accordingly. Complete response was achieved in 3/29 (10.3%) and 3/16 (17.6%) patients after six and 12 months of treatment, respectively, partial response in 13/29 (44.8%) and 5/16 (29.4%) patients, respectively, and stable disease in 13/29 (44.8%) and 8/16 (50.0%) patients, respectively. Progression of the disease was experienced by 7/42 (16.6%) patients within the period of 3–28 months of treatment. One patient with brain metastases died due to the progression of the disease. Adverse events were reported in 31/42 (73.8%) patients, more than one adverse event in a single patient was reported in 22/42 (52.3%) patients. No serious adverse events were observed. 

Article available in PDF format

View PDF Download PDF file

References

  1. Krajowy Rejestr Nowotworów - http://onkologia. org pl/nowotwory-skory-c44.
  2. Flohil SC, de Vries E, Neumann HA, et al. Incidence, prevalence and future trends of primary basal cell carcinoma in the Netherlands. Acta Derm Venereol. 2011; 91(1): 24–30.
  3. Bichakjian CK, Alam M, Kim JYS, et al. Work Group, Invited Reviewers. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol. 2018; 78(3): 540–559.
  4. Sekulic A, et al. Migden MR, Oro AE. Efficacy and Safety of Vismodegib in Advanced Basal-Cell Carcinoma, N Engl J Med. 2012; 366: 2171–9.
  5. Basset-Seguin N, Hauschild A, Grob JJ, et al. Vismodegib in patients with advanced basal cell carcinoma (STEVIE): a pre-planned interim analysis of an international, open-label trial. The Lancet Oncology. 2015; 16(6): 729–736.
  6. Wismodegib - Charakterystyka produktu leczniczego. https://www.roche.pl/content/dam/roche_poland_rwd/pl_PL/documents/SmPC/erivedge.pdf.
  7. Eastern Cooperative Oncology Group (ECOG) http://www.npcrc.org/files/news/ECOG_performance_status.pdf.
  8. Załącznik B. 88. do programu leczenia zaawansowanego raka podstawnokomórkowego wismodegibem. http://onkologia-online pl/upload/obwieszczenie/2016 12 28/b/b. ; 88: pdf.
  9. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 Published: November 27, 2017 U.S. Department Of Health And Human Services https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf.
  10. Płużański A. Kryteria oceny odpowiedzi na leczenie RECIST 1.1. Nowotwory. Journal of Oncology. 2014; 64(4): 331–335.
  11. Chang AL, Solomon JA, Hainsworth JD, et al. Expanded access study of patients with advanced basal cell carcinoma treated with the Hedgehog pathway inhibitor, vismodegib. J Am Acad Dermatol. 2014; 70(1): 60–69.
  12. Lacouture M, Guillen J, Kudchadkar R, et al. 3341 The RegiSONIC Disease Registry Study: Safety and effectiveness of vismodegib or surgery as primary treatment in patients with locally advanced basal cell carcinoma. European Journal of Cancer. 2015; 51: S679–S680.
  13. Chang AL, Arron ST, Migden MR, et al. Safety and efficacy of vismodegib in patients with basal cell carcinoma nevus syndrome: pooled analysis of two trials. Orphanet J Rare Dis. 2016; 11(1): 120.
  14. Sekulic A, Migden MR, Basset-Seguin N, et al. ERIVANCE BCC Investigators. Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: final update of the pivotal ERIVANCE BCC study. BMC Cancer. 2017; 17(1): 332.
  15. Zhao J, Quan H, Xie C, et al. NL-103, a novel dual-targeted inhibitor of histone deacetylases and hedgehog pathway, effectively overcomes vismodegib resistance conferred by Smo mutations. Pharmacol Res Perspect. 2014; 2(3): e00043.
  16. Kwon GP, Ally MS, Bailey-Healy I, et al. Update to an open-label clinical trial of vismodegib as neoadjuvant before surgery for high-risk basal cell carcinoma (BCC). J Am Acad Dermatol. 2016; 75(1): 213–215.
  17. Gathings RM, Orscheln CS, Huang WW. Compassionate use of vismodegib and adjuvant radiotherapy in the treatment of multiple locally advanced and inoperable basal cell carcinomas and squamous cell carcinomas of the skin. J Am Acad Dermatol. 2014; 70(4): e88–e89.
  18. Rutkowski P, Owczarek W. (eds). Skin carcinomas. Oncol Clin Pract. 2018; 14(3): 129–147.