Vismodegib for radiation-induced multiple basal cell carcinomas (BCCs) of the scalp

Background Vismodegib has been approved for treatment of locally advanced or metastatic basal cell carcinoma (BCC). Its use for postirradiation multiple BCCs has not yet been reported. Objective We sought to investigate the effectiveness and safety of vismodegib for the treatment of recurrent radiation-induced multiple BCCs. Methods Patients with recurrent multiple BCCs treated with vismodegib and a history of exposure to radiation treatment were followed up prospectively at a tertiary dermato-oncology clinic during a 19-month period. Results Eight patients met the study criteria. Mean duration of vismodegib treatment was 29 weeks (range 2-52), and of follow-up, 34 weeks (range 8-64). Drug tolerability was acceptable in 7 patients, of whom 4 showed a partial response and 3 had stable disease. In 1 patient, vismodegib was discontinued soon after its initiation because of a severe drug-induced eruption. Limitations Small sample size and short follow-up time are limitations. Conclusion Vismodegib holds promise for the treatment of the subpopulation of patients with radiation-induced multiple BCCs in whom therapeutic options have so far been limited.