Basal Cell Carcinoma and vismodegib- a new therapeutic advancement
David T. Harvey, MD Mohs Surgeon & Cosmetic Dermatologist
Basal Cell Carcinoma (BCC) is the most common type of skin cancer accounting for about 3 million cases per year in the US. This cancer is a more locally destructive force and has less risk for metastatic invasion when compared to malignant melanoma.
Depending on the type of BCC, options from topical creams to surgery may be recommended. One of the more recent advances in basal cell carcinoma therapy has come into play for locally advanced tumors. A new oral medication, vismodegib (Erivedge), has shown promise to treat BCC that are locally advanced, recurrent or widespread, e.g. as reflected in the genetic condition called Basal cell nevus syndrome.
Vismodegib has been shown to shrink high risk locally advanced tumors either as a solitary therapy or in conjunction with surgery. In our surgical practice, I find this to be an exciting advancement, because it may allow our patients to experience less morbidity for large tumors on the eyelid, nose, or ear. If we could completely or significantly diminish tumor size and then verify clear surgical margins on a smaller sized tumor, this would be of great benefit to our patients.
Current studies on how adjuvant therapies can be combined with standard surgery are being undertaken. We are looking forward to seeing how these advances play out, and specifically, how they will influence our practice patterns for the treatment of basal cell carcinoma in the near future.