When basal cell carcinoma of the skin has spread beyond the primary site, the clinical management differs substantially from localised disease. Metastatic BCC requires a coordinated, systemic approach rather than local or surgical measures alone.
This protocol addresses patients with metastatic basal cell carcinoma — disease that has disseminated systemically. In this setting, multidisciplinary consultation is a recommended cornerstone of management before initiating therapy.
The approach combines multidisciplinary consultation with systemic therapy directed at the hedgehog signalling pathway. The full regimen, agent selection, and clinical decision algorithm are available in the complete protocol.
The primary clinical target is objective tumour response — measurable shrinkage of metastatic disease. The majority of patients in clinical studies experienced tumour shrinkage, though responses are typically partial.
DOI: 10.1016/j.jaad.2017.10.006
Multidisciplinary consultation and smoothened inhibitors are recommended for patients with metastatic BCC.
Oral vismodegib has been approved by the US Food and Drug Administration as the first systemic therapy for metastatic BCC.
Although all the responses were partial, the majority of patients (73%) experienced tumor shrinkage, with a median duration of objective response of 7.6 months.
View source ↗