Treatment of Metastatic Basal Cell Carcinoma of Skin

Metastatic basal cell carcinoma (mBCC) is the most advanced presentation of this disease, requiring systemic intervention. The treatment strategy differs substantially from approaches used in localised or early-stage disease.

Clinical Scenario

Advanced basal cell carcinoma encompasses both locally advanced BCC (laBCC) and metastatic BCC (mBCC). This protocol addresses the metastatic setting, where disease has spread beyond the primary skin site.

Treatment Approach

An oral agent targeting the Hedgehog signalling pathway is the established systemic intervention for metastatic BCC. The full protocol details which specific agents are indicated, the eligibility criteria, and the complete treatment algorithm.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.ejca.2023.113254

Advanced BCC includes locally advanced BCC (laBCC) and metastatic BCC (mBCC).

Hedgehog inhibitors should be offered to patients with locally advanced or metastatic BCC.

Vismodegib and sonidegib are specific inhibitors of an oncogenic protein named Smoothened and are both approved by FDA and EMA for the treatment of patients with laBCC who are not candidates for surgery or radiotherapy; vismodegib is also approved for mBCC whereas sonidegib is approved for mBCC only in Switzerland and Australia.

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