This protocol covers locally advanced basal cell carcinoma (BCC) in patients who have at least one tumor 10 mm or larger in diameter that is inoperable or otherwise inappropriate for surgical resection. The determination of surgical inoperability or inappropriateness is made by a specialist in Mohs micrographic surgery, head and neck surgery, or plastic surgery.
When surgery (and radiation) are not viable options, evidence supports systemic therapy directed at the hedgehog signalling pathway. The complete protocol specifies which agents are involved and how they are applied — the full regimen is available via the link below.
The primary objective is objective reduction in tumor size. The structured protocol defines how response is evaluated and what constitutes a meaningful treatment outcome.
DOI: 10.1016/j.jaad.2017.10.006
Patients had at least 1 tumor 10 mm or larger in diameter that was considered inoperable or inappropriate for surgery in the opinion of a specialist in MMS, head and neck surgery, or plastic surgery.
If surgery and radiation therapy are contraindicated or inappropriate for the treatment of locally advanced BCC, or if residual tumor persists following surgery and/or radiation therapy and further surgery and radiation therapy are contraindicated or inappropriate, systemic therapy with a smoothened inhibitor should be considered.
Comparable findings were more recently reported with use of another SMO inhibitor, sonidegib, in patients with locally advanced BCC.
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