H Oliphant1,2, J Laybourne3, K Chan4, A Haridas5, M R Edmunds5, D Morris5, L Clarke6, M Althaus6, P Norris7, M Cranstoun8, T J Sullivan8, S N Rajak9,10. 1. Sussex Eye Hospital, Brighton Sussex University Hospital, Eastern Road, Brighton, BN2 5BF, UK. huw.oliphant@nhs.net. 2. Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, UK. huw.oliphant@nhs.net. 3. Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK. 4. Department of Ophthalmology, 23 Mein Street, Newtown, Wellington, 6021, New Zealand. 5. Cardiff Eye Unit, University Hospital of Wales, Heath Park Way, Cardiff, CF14 4XW, UK. 6. Newcastle Eye Centre, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK. 7. Department of Oral and Maxillofacial Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead, RH19 3DZ, UK. 8. Department of Ophthalmology, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia. 9. Sussex Eye Hospital, Brighton Sussex University Hospital, Eastern Road, Brighton, BN2 5BF, UK. 10. Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, UK.
Abstract
INTRODUCTION: Vismodegib (Erivedge, Genentech) is a first-in-class inhibitor of the hedgehog (Hh) pathway, which is licensed for use in locally advanced basal cell carcinoma (BCC) and metastatic BCC. The National Institute for Health and Care Excellence withdrew recommendation for use of vismodegib secondary to a lack of data comparing vismodegib to standard supportive care. The purpose of this multicentre, international case series is to report outcomes of patients with locally advanced periocular BCC who have been treated with vismodegib. METHODS: The medical records of all patients treated with vismodegib were retrospectively reviewed across seven institutions in the United Kingdom, Australia, and New Zealand. RESULTS: Thirteen patients were identified. Seven (54%) patients were male. All BCCs were ill-defined, with seven (58%) having orbital involvement at presentation. Median treatment time was 7 months (range 2-36 months). Eleven out of 13 patients developed side effects, the most common being fatigue in six patients (46%). Median follow-up was 24 months (range 12-48 months). Complete response was found in 5/13 patients (38%) and a partial response in 8/13 patients (62%). Six patients had further surgery after vismodegib, with three classed as globe-sparing operations. Three patients developed recurrence (23%). Three patients (23%) ultimately underwent exenteration. DISCUSSION: This study demonstrates vismodegib to be a well-tolerated treatment which may, in some cases, facilitate globe-sparing surgery and hence avoid disfiguring operations such as exenteration. Uncertainty does remain regarding the long-term outcomes of patients treated with vismodegib.
INTRODUCTION: Vismodegib (Erivedge, Genentech) is a first-in-class inhibitor of the hedgehog (Hh) pathway, which is licensed for use in locally advanced basal cell carcinoma (BCC) and metastatic BCC. The National Institute for Health and Care Excellence withdrew recommendation for use of vismodegib secondary to a lack of data comparing vismodegib to standard supportive care. The purpose of this multicentre, international case series is to report outcomes of patients with locally advanced periocular BCC who have been treated with vismodegib. METHODS: The medical records of all patients treated with vismodegib were retrospectively reviewed across seven institutions in the United Kingdom, Australia, and New Zealand. RESULTS: Thirteen patients were identified. Seven (54%) patients were male. All BCCs were ill-defined, with seven (58%) having orbital involvement at presentation. Median treatment time was 7 months (range 2-36 months). Eleven out of 13 patients developed side effects, the most common being fatigue in six patients (46%). Median follow-up was 24 months (range 12-48 months). Complete response was found in 5/13 patients (38%) and a partial response in 8/13 patients (62%). Six patients had further surgery after vismodegib, with three classed as globe-sparing operations. Three patients developed recurrence (23%). Three patients (23%) ultimately underwent exenteration. DISCUSSION: This study demonstrates vismodegib to be a well-tolerated treatment which may, in some cases, facilitate globe-sparing surgery and hence avoid disfiguring operations such as exenteration. Uncertainty does remain regarding the long-term outcomes of patients treated with vismodegib.
Authors: Maya Eiger-Moscovich; Ehud Reich; Gil Tauber; Ori Berliner; Ayelet Priel; Guy Ben Simon; Amir Abd Elkader; Iftach Yassur Journal: Am J Ophthalmol Date: 2019-05-09 Impact factor: 5.258
Authors: Aleksandar Sekulic; Michael R Migden; Nicole Basset-Seguin; Claus Garbe; Anja Gesierich; Christopher D Lao; Chris Miller; Laurent Mortier; Dedee F Murrell; Omid Hamid; Jorge F Quevedo; Jeannie Hou; Edward McKenna; Natalie Dimier; Sarah Williams; Dirk Schadendorf; Axel Hauschild Journal: BMC Cancer Date: 2017-05-16 Impact factor: 4.430