Treatment of Recurrent or High-Risk Basal Cell Carcinoma of Skin
Basal cell carcinoma presenting with recurrence or specific high-risk features requires a more structured management approach. This protocol addresses the clinical scenarios where standard treatment is insufficient and evidence-based escalation is indicated.
Clinical Scenario
- Recurrent basal cell carcinoma
- Aggressive histopathological subtype
- Location on a critical anatomical site
- Poorly defined tumour margins
- Perineural invasion
- Multiple basal cell carcinomas
Treatment Approach
For eligible patients in this high-risk population, the protocol includes anti-PD1 immunotherapy as a key systemic treatment option.
Full regimen details, sequencing, and criteria are available in the complete protocol.
References
DOI: 10.1016/j.ejca.2023.113254
- Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites.
- Micrographically controlled surgery (3D) shall be offered in high-risk BCC (recurrent, aggressive subtypes, location in critical anatomical sites, poorly defined margins).
- Anti-PD1 immunotherapy should be offered as second-line treatment in patients who progress or have contraindications to hedgehog inhibitors.
- Eighty-four laBCC patients received cemiplimab with the conventional dose of 350 mg intravenously every 3 weeks for up to 93 weeks or until progression or unacceptable toxicity.
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