Advanced basal cell cancer: concise review of molecular characteristics and novel targeted and immune therapeutics

Annals of Oncology : Official Journal of the European Society for Medical Oncology
M NikanjamR Kurzrock

Abstract

Metastatic basal cell carcinoma is an ultra-rare manifestation of a common disease, appearing in 0.0028%-0.5% of basal cell carcinomas. Initial therapeutic efforts focused on cytotoxic chemotherapy administration. However, it is now known that the Hedgehog signaling pathway is crucial for basal cell proliferation and Hedgehog pathway mutations may lead to tumorigenesis; thus, small-molecule inhibitors of alterations in the components of this pathway, including smoothened (SMO) and GLI, have been the focus of recent therapeutic developments. Indeed, the European Medicines Agency and the Food and Drug Administration have approved the SMO inhibitors, vismodegib and sonidegib, with additional GLI inhibitors currently in clinical trials. Molecular profiling of these tumors has revealed other potential targets for therapy, including high tumor mutational burden and PD-L1 amplification, which predict response to immune checkpoint blockade (PD-1 and PD-L1 inhibitors). An illustrative patient with a giant, advanced, unresectable basal cell carcinoma who obtained an ongoing complete remission after treatment with a combination of an immune checkpoint inhibitor (due to the tumor's high mutational burden) and the Hedgehog inhibitor vismode...Continue Reading

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Citations

Jul 30, 2019·American Journal of Clinical Pathology·Alvaro C LagaJohn Hanna
Jun 11, 2019·Seminars in Ophthalmology·Larissa A HabibMichael K Yoon
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Sep 5, 2020·Biomedicine Hub·Philip R CohenAntoanella Calame

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