Vismodegib voor gevorderd basaalcelcarcinoom

The development of the hedgehog pathway inhibitor vismodegib provides a new treatment option for metastasised and locally advanced basal cell carcinoma in which surgical excision or radiotherapy is contraindicated. Only a fraction of patients with basal cell carcinoma are eligible for this therapy, but it is effective in the majority of those who do receive vismodegib. However, development of tumour resistance is quite common and adverse events frequently lead to discontinuation of therapy. Intermittent treatment or combination therapy could reduce the occurrence of tumour resistance and diminish toxicity. We present three patients who were successfully treated with vismodegib: a 73-year-old man with locally advanced basal cell carcinoma, an 82-year-old man with basal cell carcinoma that had metastasised to the lungs, and a 42-year-old man with Gorlin syndrome.

Conflict of interest and financial support: the institute of M.G.H.C. Reinders and K. Mosterd (MUMC+, Dept. Dermatology), the institute of J.B. Terra (UMCG, Dept. Dermatology) and the institute of A.K.L. Reyners (UMCG, Dept. Medical Oncology) have received payment from Roche for including patients in the MIKIE and STEVIE studies; the institute of E.R.M. de Haas (Erasmus MC, Dept. Dermatology) took part in the STEVIE study; K. Mosterd has received personal fees for participating in Roche’s advisory board and for participating in Novartis’ advisory board; E.R.M. de Haas was member of Roche’s advisory board and was involved in organising a masterclass in 2014 and 2015.