BCC: does histologic subtype affect response to oral vismodegib?

  • J Am Acad Dermatol

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • The histopathologic subtype of basal cell carcinoma (BCC) is not associated with response rate to oral vismodegib, according to a small, phase 2b study.

Why this matters

  • The effect of subtype on response to vismodegib, previously demonstrated in the ERIVANCE trial, was unclear.

Key results

  • Clinical response rates:
    • 20% complete response,
    • 41.5% partial response,
    • 36.9% stable disease, and
    • 1.5% progressive disease.
  • At 24 weeks, most BCCs achieved histologic clearance, with positive biopsies in:
    • 10.5% of target lesions,
    • 30.4% of nontarget lesions, and
    • 21.4% overall.
  • No statistical differences in histologic clearance rates were seen between histopathologic subtypes.
  • The most common treatment-emergent adverse events were dysgeusia/loss of taste (86%), muscle spasms (82%), and alopecia (71%).

Study design

  • 27 patients with BCC who received vismodegib were included.
  • Patients had 27 target lesions (15 infiltrative, 5 nodular, 7 superficial) and 38 nontarget lesions (9 infiltrative, 3 superficial, 24 nodular, 2 keratotic).
  • Funding: Genentech/Roche.

Limitations

  • Small patient sample size.
  • Open-label trial.