Vismodegib

Excerpt

Initially approved in 2012, vismodegib is the first FDA-approved pharmacologic agent that targets the Hedgehog signaling pathway (sonic hedgehog, SHH), a pathway involved in many basal cell carcinomas. Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer (NMSC), accounting for over one-half of all NMSC diagnoses. BCC affects over 3.3 million a year in the United States. Approximately 40% of patients diagnosed with BCC will develop another BCC within five years of the initial diagnosis. Management is primarily with surgical intervention, except in some cases where topical therapy is utilized. Not all patients are suitable candidates for surgery or topical treatment due to locally advanced or metastatic basal cell carcinoma; this is where vismodegib has a place in therapy. This activity outlines the indications, mechanism of action, methods of administration, significant adverse effects, contraindications, toxicity, and monitoring, of vismodegib so providers can direct patient therapy in cancer treatment where it is indicated as part of the interprofessional team.