Rapid response to vismodegib in a patient with advanced basal cell carcinoma

BCC: Basal cell carcinoma INTRODUCTION Basal cell carcinoma (BCC) is the most common form of skin cancer, making up approximately 80% of all nonmelanoma skin cancers. Traditional therapy includes various types of surgery (Mohs, cryosurgery, excision, electrodessication and curettage), topical therapies (5-fluorouracil, imiquimod), or radiation therapy. A new and effective treatment, vismodegib, became available recently. The mechanism of action of vismodegib is based on inhibition of the Hedgehog pathway, which is responsible for cell growth in more than 90% of BCC cases. Response rates of 30% in metastatic disease and 43% in locally advanced disease, with complete response in half the patients with locally advanced disease, have been reported. Despite the large amount of data concerning response rate and response duration of this Hedgehog signaling pathwayetargeting agent, there is no published information about time to response. This information is often requested by patients before treatment commences. The current case of locally advanced BCC, which responded quickly to treatment with vismodegib and showed signs of wound healing at the first assessment after 4 weeks, represents the type of information that patients request before treatment initiation.