gdc-0449 and Facial-Neoplasms

Topics: Aged; Aged, 80 and over; Anilides; Antineoplastic Agents; Carcinoma, Basal Cell; Chemotherapy, Adjuvant; Facial Neoplasms; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mohs Surgery; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Pyridines; Skin Neoplasms; Tumor Burden

Topics: Administration, Oral; Aged; Anilides; Antineoplastic Agents; Brain; Carcinoma, Basal Cell; Facial Neoplasms; Humans; Magnetic Resonance Imaging; Male; Neoplasm Invasiveness; Pyridines; Skin Neoplasms; Treatment Outcome

Topics: Administration, Oral; Aged, 80 and over; Anilides; Antineoplastic Agents; Carcinoma, Basal Cell; Cell Differentiation; Drug Resistance, Neoplasm; Facial Neoplasms; Female; Humans; Mohs Surgery; Nose Neoplasms; Pyridines; Surgical Flaps

Vismodegib is an oral inhibitor of the Hedgehog signaling pathway and has been used to treat basal cell carcinoma (BCC) in adults. This article reports clearance of a nodular BCC of the nasal tip in an 8-year-old boy with xeroderma pigmentosum (XP). BCC can pose therapeutic challenges when located in areas that are not amenable to traditional therapies such as Mohs micrographic surgery or topical agents. Vismodegib was used at a dose of 150 mg/day to treat the boy's BCC. After 4 months of therapy, we achieved complete clinical clearance. During 21 months of follow-up, the patient's nose remained clinically clear of tumor. Vismodegib was successfully used to treat a child with XP and nodular BCC. Our goal in using vismodegib was tumor regression while avoiding cosmetic and functional disfigurement. Vismodegib was effective in clinically clearing the tumor, and the patient has shown no signs of recurrence. Further studies are warranted.

Topics: Anilides; Carcinoma, Basal Cell; Child; Facial Neoplasms; Humans; Male; Nose; Pyridines; Skin Neoplasms; Xeroderma Pigmentosum

Topics: Aged; Anilides; Antineoplastic Agents; Carcinoma, Basal Cell; Facial Neoplasms; Humans; Male; Pyridines; Skin Neoplasms

Basal cell carcinoma (BCC) is the most common cancer in humans. Vismodegib, a Hedgehog pathway inhibitor, has proved its effectiveness in treating non-resectable advanced BCC.. However, its action on squamous cell carcinoma (SCC) is unknown. We present three SCC cases developed into BCC in vismodegib-treated patients.. We have described three cases of patients developing SCC during treatment by vismodegib for BCC.. Patient 1 was treated with vismodegib for five facial BCC. Due to the progression of one of the lesions at month 3 (M3), a biopsy was performed and showed SCC. Patient 2 was treated with vismodegib for a large facial BCC. A biopsy was performed at M2 on a BCC area not responding to treatment and showed SCC. Patient 3 was treated with vismodegib for a BCC on the nose. Due to vismodegib ineffectiveness, a biopsy was performed and showed SCC.. Two similar cases have been described in the literature. This could be due to the appearance of the squamous contingent of a metatypical BCC or to the squamous differentiation of stem cells through inhibition of the hedgehog pathway.. In practice, any dissociated response of a BCC to vismodegib should be biopsied.

Topics: Aged; Aged, 80 and over; Anilides; Antineoplastic Agents; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Facial Neoplasms; Female; Humans; Male; Middle Aged; Neoplasms, Second Primary; Pyridines; Skin Neoplasms

Immunosuppressed patients with solid organ transplants have an increased risk for nonmelanoma skin cancer. Vismodegib has been reported to be effective for select locally advanced or metastatic basal cell carcinomas. However, there is no data documenting the use and safety of vismodegib in immunosuppressed organ transplant patients.. We describe a 78-year-old white man with a history of orthotopic heart transplant, immunosuppressed with low-dose cyclosporine, who presented to a specialty dermatology transplant clinic with multiple, recurrent, locally aggressive facial basal cell carcinomas. Through a multidisciplinary approach, the patient was started on vismodegib therapy. The pharmacokinetics of cyclosporine in the setting of vismodegib administration and weekly monitoring of cyclosporine levels ensured that therapeutic immunosuppression levels were achieved without toxic effects.. To our knowledge, this is the first report that details vismodegib use in an immunosuppressed heart transplant patient receiving cyclosporine therapy. With a growing immunosuppressed organ transplant population at high risk for basal cell carcinoma, therapeutic options for locally advanced or metastatic disease are limited. Vismodegib appears to be a safe option for patients receiving cyclosporine therapy with routine monitoring. Future research is needed to evaluate the safety profile of vismodegib with other immunosuppressive agents.

Topics: Aged; Anilides; Antineoplastic Agents; Carcinoma, Basal Cell; Cyclosporine; Drug Monitoring; Facial Neoplasms; Heart Transplantation; Humans; Immunocompromised Host; Immunosuppressive Agents; Male; Pyridines; Skin Neoplasms

Vismodegib therapy achieves a breakthrough in patients with locally advanced basal cell carcinoma (BCC). Yet, long-term safety of hedgehog pathway inhibitors remains to be established, while drug resistance is becoming a new challenging issue.. We report the case of a 90-year-old male initially referred for a locally advanced BCC of the nose. He had been previously treated by topical 5-fluorouracil for an adjacent microinvasive squamous cell carcinoma (SCC), with complete clinical response. Afterwards, vismodegib was initiated to treat his BCC. At week 16, both tumor and tumor ulceration obviously progressed. Palliative rhinectomy was performed. Histological examination found a deeply invasive SCC.. Although our case must be interpreted with caution, a role of vismodegib as a promoter of cutaneous SCC should be considered, consistently with recently published evidence. Physicians should perform new biopsies whenever in doubt about new and/or progressive skin lesions in patients receiving hedgehog pathway inhibitors.

Topics: Aged, 80 and over; Anilides; Antimetabolites, Antineoplastic; Antineoplastic Agents; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Facial Neoplasms; Fluorouracil; Humans; Male; Nose Neoplasms; Pyridines; Skin Neoplasms

Topics: Aged, 80 and over; Anilides; Carcinoma, Basal Cell; Deglutition Disorders; Facial Neoplasms; Female; Humans; Pyridines; Skin Neoplasms

This case series explores the use of vismodegib to treat locally advanced basal cell carcinoma (laBCC), with a focus on tolerability, efficacy, and outcomes after treatment cessation.. Data from patients who underwent vismodegib treatment for laBCC at a single institution from 3/6/2012 through 3/15/2015 was utilized in this study. For all included cases, treatment responses as recorded at the first follow-up after treatment cessation were assessed and are reported as complete clinical response (CCR), partial clinical response (PCR), stable disease, or progressive disease. In cases of CCR, clinical disease free survival (DFS) was calculated as the time from cessation of vismodegib until last available follow-up, death, or recurrence. Data pertaining to side effects and adverse events was also recorded, and results are presented using descriptive statistics.. A total of 24 patients and 31 tumors met inclusion criteria. CCR was observed in 17 of 31 tumors (55%), and 13 of 31 tumors (42%) demonstrated PCR. Stable disease was seen in one patient (one tumor) (3%). No cases demonstrated clinical tumor progression during treatment. The mean clinical DFS at time of data cut off for all cases of CCR was 9.3 months (range 2-21 months). In cases of PCR, the mean reduction in tumor size was 52% (range, 11%-80%). Only two patients (8%) discontinued treatment secondary to side effects.. Each patient and each tumor responds uniquely to vismodegib treatment, including variable tumor responses and a wide range of side effects and tolerability. This study highlights important unique observations, and our data as a whole adds to previously published studies, leading to thought provoking questions. Overall, the FDA approval of vismodegib for advanced basal cell carcinoma has markedly improved the prognosis and care of affected patients.

Topics: Adult; Aged; Aged, 80 and over; Anilides; Antineoplastic Agents; Carcinoma, Basal Cell; Cheek; Disease Progression; Disease-Free Survival; Facial Neoplasms; Female; Follow-Up Studies; Forehead; Humans; Male; Middle Aged; Nose; Pyridines; Scalp; Skin Neoplasms; Thorax; Treatment Outcome; Tumor Burden

Topics: Anilides; Antineoplastic Agents; Carcinoma, Basal Cell; Facial Neoplasms; Heart Failure; Humans; Male; Middle Aged; Neoplasms, Second Primary; Photochemotherapy; Pyridines; Skin Neoplasms

Topics: Adult; Aged, 80 and over; Anilides; Antineoplastic Agents; Basal Cell Nevus Syndrome; Drug Resistance, Neoplasm; Facial Neoplasms; Female; Hedgehog Proteins; Humans; Male; Patched Receptors; Pyridines; Receptors, Cell Surface; Receptors, G-Protein-Coupled; Smoothened Receptor; Switzerland