gdc-0449 and Spinal-Neoplasms

Historically, basal cell carcinomas (BCCs) that are neither surgically resectable nor candidates for radiation therapy have had few treatment options. The hedgehog pathway inhibitor, vismodegib, represents a new opportunity for the treatment of such patients. Vismodegib has approval from the United States Food and Drug Administration for treatment of metastatic BCC, locally advanced BCC recurring after surgery, and BCC that is not treatable via surgery or radiation. We present the case of a patient with a BCC infiltrating the spinal column that was neither possible to fully remove surgically nor a candidate for primary treatment with radiation. Treatment with vismodegib followed by adjuvant radiation therapy resulted in complete disease clearance. Vismodegib represents a promising treatment option for patients with surgically non-resectable BCCs that are not candidates for radiation therapy. Mechanism of action, benefits, and adverse events of vismodegib are reviewed, along with a brief discussion on newer options in the hedgehog inhibitor class.

Topics: Aged; Anilides; Biopsy; Carcinoma, Basal Cell; Drug Approval; Hedgehog Proteins; Humans; Male; Neoplasm Invasiveness; Postoperative Care; Pyridines; Skin Neoplasms; Spinal Neoplasms; Tomography, X-Ray Computed; United States; United States Food and Drug Administration