Sonidegib (Odomzo) for the Systemic Treatment of Adults With Recurrent, Locally Advanced Basal Cell Skin Cancer.

INTRODUCTION Non-melanoma skin cancer (NMSC) is the most common malignancy in the United States, with more than 5.4 million cases diagnosed annually.1 NMSC is categorized as either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), with BCC occurring at a fourfold to fi vefold higher rate than SCC. Standard fi rst-line treatment of BCC usually involves local procedures, such as curettage, electrodessication, surgical excision, or radiation therapy.2 In the most recent data (from 2011), total health care expenditures for cancer treatments in the U.S. were estimated to exceed $88 billion, including $4.8 billion for NMSC.3,4 While the cost of treating NMSC may be a small fraction of the overall cost of cancer therapies, additional factors must be considered. For instance, the rate of BCC is expected to grow as specifi c populations expand, such as people older than 65 years of age, immunosuppressed patients, and previously treated patients experiencing disease recurrence; this may increase costs.5 Estimates of the rate of locally advanced BCC (laBCC) or metastatic BCC (mBCC) are elusive because of a lack of standardization in staging and reporting requirements, but it has been estimated that laBCC occurs in 1% to 10% of BCC patients, and that mBCC occurs in 0.0028% to 0.5% of BCC patients.6 Patients with mBCC have a median survival of eight months.7 Until recently, only limited treatment options,