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Review
. 2014 Feb 9;3(1):40-45.
doi: 10.1007/s13671-014-0069-y. eCollection 2014.

Advanced Basal Cell Carcinoma: Epidemiology and Therapeutic Innovations

Shalini V Mohan  1 , Anne Lynn S Chang  1
Affiliations
Review

Advanced Basal Cell Carcinoma: Epidemiology and Therapeutic Innovations

Shalini V Mohan et al. Curr Dermatol Rep. .

Abstract

Advanced basal cell carcinomas are a subset of basal cell carcinomas that can be difficult to treat either due to their local invasiveness, proximity to vital structures, or metastasis. The incidence of all basal cell carcinoma is increasing in the United States, although it is not known whether advanced basal cell carcinomas (aBCCs) are also increasing. Recently, highly targeted therapy based on knowledge of the basal cell carcinoma pathogenesis has become available either commercially or through human clinical trials. These orally available drugs inhibit the Hedgehog signaling pathway, and lead to advanced basal cell carcinoma shrinkage that can enable preservation of adjacent vital organs. In this review, we outline the role of Hedgehog pathway inhibitors as well as other treatment modalities such as excision, radiotherapy and more traditional chemotherapy in treating advanced basal cell carcinomas. We also highlight current gaps in knowledge regarding the use and side effects of this targeted therapy.

Keywords: Advanced basal cell carcinoma; Basal cell carcinoma; Basal cell nevus syndrome; Gorlin’s syndrome; Hedgehog pathway inhibitors; Metastatic basal cell carcinoma; Smoothened inhibitors; Targeted therapy; Vismodegib.

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Conflict of interest statement

SV Mohan declares no conflicts of interest.

ALS Chang has received research support from Genentech, Novartis, Infinity, and Lilly.

Figures

Fig. 1
Fig. 1
Simplified schematic of common mutations in the Hedgehog signaling pathway leading to basal cell carcinoma from pathway activation (a), and therapeutic targets of this pathway (b)
Fig. 2
Fig. 2
Example treatment algorithm for advanced basal cell carcinoma. Due to disease heterogeneity in advanced basal cell carcinomas, actual treatment depends on tumor location, prior treatments and patient comorbidities
See this image and copyright information in PMC

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