Pathologic complete response with radiation and vismodegib in a patient with advanced basal cell carcinoma: A case report

Amini,Arya; Freeman,Morganna; Melstrom,Laleh; Margolin,Kim A.; Parekh,Vishwas; Abdulla,Farah R.; Modi,Badri

doi:10.3892/mco.2021.2208

Pathologic complete response with radiation and vismodegib in a patient with advanced basal cell carcinoma: A case report

Authors:
- Arya Amini
- Morganna Freeman
- Laleh Melstrom
- Kim A. Margolin
- Vishwas Parekh
- Farah R. Abdulla
- Badri Modi
View Affiliations

Affiliations: Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA 91010, USA, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, USA, Department of Surgery, City of Hope National Medical Center, Duarte, CA 91010, USA, Department of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA, Division of Dermatology, City of Hope National Medical Center, Duarte, CA 91010, USA
Published online on: January 13, 2021 https://doi.org/10.3892/mco.2021.2208
Article Number: 46
Copyright: © Amini et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

In locally advanced basal cell carcinoma (BCC) patients who are not surgical candidates and where radiation therapy (RT) alone would offer lower control rates, the combination of vismodegib and RT delivered concurrently may potentially improve outcomes compared to single modality treatment. The current study presents a case of very advanced, multifocal BCC who received concurrent vismodegib and RT. The patient initially came in with four large primary areas of disease including the left preauriculum, right shoulder, chest wall and right lateral ankle. All sites achieved a clinical complete response, with a pathologic complete response at the right shoulder. The ankle lesion did not require RT and continues to have a clinical complete response. The findings from our case report support several other cases with similar efficacy when vismodegib and RT are combined.

View Figures

View References

1	Cameron MC, Lee E, Hibler BP, Barker CA, Mori S, Cordova M, Nehal KS and Rossi A: Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. J Am Acad Dermatol. 80:303–317. 2019.PubMed/NCBI View Article : Google Scholar
2	Likhacheva A, Awan M, Barker CA, Bhatnagar A, Bradfield L, Brady MS, Buzurovic I, Geiger JL, Parvathaneni U, Zaky S and Devlin PM: Definitive and postoperative radiation therapy for basal and squamous cell cancers of the skin: Executive summary of an American society for radiation oncology clinical practice guideline. Pract Radiat Oncol. 10:8–20. 2020.PubMed/NCBI View Article : Google Scholar
3	Wilder RB, Kittelson JM and Shimm DS: Basal cell carcinoma treated with radiation therapy. Cancer. 68:2134–2137. 1991.PubMed/NCBI View Article : Google Scholar
4	Armstrong P, Martin S and Lask G: Sonic hedgehog pathway inhibition in the treatment of advanced basal cell carcinoma. In: Biologic and Systemic Agents in Dermatology. Springer, Cham, pp541-548, 2018.
5	Sekulic A, Migden MR, Oro AE, Dirix L, Lewis KD, Hainsworth JD, Solomon JA, Yoo S, Arron ST, Friedlander PA, et al: Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med. 366:2171–2179. 2012.PubMed/NCBI View Article : Google Scholar
6	Sekulic A, Migden MR, Lewis K, Hainsworth JD, Solomon JA, Yoo S, Arron ST, Friedlander PA, Marmur E, Rudin CM, et al: Pivotal ERIVANCE basal cell carcinoma (BCC) study: 12-month update of efficacy and safety of vismodegib in advanced BCC. J Am Acad Dermatol. 72:1021–1026.e8. 2015.PubMed/NCBI View Article : Google Scholar
7	Hehlgans S, Booms P, Güllülü Ö, Sader R, Rödel C, Balermpas P, Rödel F and Ghanaati S: Radiation sensitization of basal cell and head and neck squamous cell carcinoma by the hedgehog pathway inhibitor vismodegib. Int J Mol Sci. 19(2485)2018.PubMed/NCBI View Article : Google Scholar
8	Franco AI, Eastwick G, Farah R, Heyboer M, Lee M and Aridgides P: Upfront radiotherapy with concurrent and adjuvant vismodegib is effective and well-tolerated in a patient with advanced, multifocal basal cell carcinoma. Case Rep Dermatol Med. 2018(2354146)2018.PubMed/NCBI View Article : Google Scholar
9	Pollom EL, Bui TT, Chang AL, Colevas AD and Hara WY: Concurrent vismodegib and radiotherapy for recurrent, advanced basal cell carcinoma. JAMA Dermatol. 151:998–1001. 2015.PubMed/NCBI View Article : Google Scholar
10	Block AM, Alite F, Diaz AZ, Borrowdale RW, Clark JI and Choi M: Combination trimodality therapy using vismodegib for basal cell carcinoma of the face. Case Rep Oncol Med. 2015(827608)2015.PubMed/NCBI View Article : Google Scholar
11	Gathings RM, Orscheln CS and 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. 70:e88–e89. 2014.PubMed/NCBI View Article : Google Scholar
12	Zeng J, Aziz K, Chettiar ST, Aftab BT, Armour M, Gajula R, Gandhi N, Salih T, Herman JM, Wong J, et al: Hedgehog pathway inhibition radiosensitizes non-small cell lung cancers. Int J Radiat Oncol Biol Phys. 86:143–149. 2013.PubMed/NCBI View Article : Google Scholar
13	Le H, Kleinerman R, Lerman OZ, Brown D, Galiano R, Gurtner GC, Warren SM, Levine JP and Saadeh PB: Hedgehog signaling is essential for normal wound healing. Wound Repair Regen. 16:768–773. 2008.PubMed/NCBI View Article : Google Scholar
14	ClinicalTrials.gov: Phase II Study of Radiation Therapy and Vismodegib for Advanced Head/Neck Basal Cell Carcinoma. ClinicalTrials.gov Identifier: NCT01835626. https://clinicaltrials.gov/ct2/show/NCT01835626. Last updated October 5, 2020.