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Vismodegib for periocular basal cell carcinoma: an international multicentre case series
Eye ( IF 2.8 ) Pub Date : 2020-01-29 , DOI: 10.1038/s41433-020-0778-3
H Oliphant 1, 2 , J Laybourne 3 , K Chan 4 , A Haridas 5 , M R Edmunds 5 , D Morris 5 , L Clarke 6 , M Althaus 6 , P Norris 7 , M Cranstoun 8 , T J Sullivan 8 , S N Rajak 1, 2
Affiliation  

Introduction Vismodegib (Erivedge, Genentech) is a first-in-class inhibitor of the hedgehog (Hh) pathway, which is licensed for use in locally advanced basal cell carcinoma (BCC) and metastatic BCC. The National Institute for Health and Care Excellence withdrew recommendation for use of vismodegib secondary to a lack of data comparing vismodegib to standard supportive care. The purpose of this multicentre, international case series is to report outcomes of patients with locally advanced periocular BCC who have been treated with vismodegib. Methods The medical records of all patients treated with vismodegib were retrospectively reviewed across seven institutions in the United Kingdom, Australia, and New Zealand. Results Thirteen patients were identified. Seven (54%) patients were male. All BCCs were ill-defined, with seven (58%) having orbital involvement at presentation. Median treatment time was 7 months (range 2–36 months). Eleven out of 13 patients developed side effects, the most common being fatigue in six patients (46%). Median follow-up was 24 months (range 12–48 months). Complete response was found in 5/13 patients (38%) and a partial response in 8/13 patients (62%). Six patients had further surgery after vismodegib, with three classed as globe-sparing operations. Three patients developed recurrence (23%). Three patients (23%) ultimately underwent exenteration. Discussion This study demonstrates vismodegib to be a well-tolerated treatment which may, in some cases, facilitate globe-sparing surgery and hence avoid disfiguring operations such as exenteration. Uncertainty does remain regarding the long-term outcomes of patients treated with vismodegib.

中文翻译:

Vismodegib 治疗眼周基底细胞癌:国际多中心病例系列

介绍 Vismodegib(Eridge,Genentech)是hedgehog (Hh) 通路的一流抑制剂,获准用于局部晚期基底细胞癌(BCC) 和转移性BCC。由于缺乏将 vismodegib 与标准支持性护理进行比较的数据,美国国家健康与护理卓越研究所撤回了使用 vismodegib 的建议。这个多中心、国际病例系列的目的是报告接受 vismodegib 治疗的局部晚期眼周 BCC 患者的结果。方法 对所有接受 vismodegib 治疗的患者的医疗记录在英国、澳大利亚和新西兰的七个机构中进行回顾性审查。结果 确定了 13 名患者。七名 (54%) 患者为男性。所有 BCC 都定义不明确,七名(58%)在就诊时有眼眶受累。中位治疗时间为 7 个月(范围 2-36 个月)。13 名患者中有 11 名出现副作用,最常见的是 6 名患者 (46%) 的疲劳。中位随访时间为 24 个月(范围 12-48 个月)。5/13 患者(38%)完全缓解,8/13 患者(62%)部分缓解。6 名患者在 vismodegib 后接受了进一步手术,其中 3 名被归类为保全手术。三名患者出现复发(23%)。三名患者 (23%) 最终接受了切除术。讨论 本研究表明 vismodegib 是一种耐受性良好的治疗方法,在某些情况下,它可以促进保全手术,从而避免毁容手术,例如切除术。
更新日期:2020-01-29
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