Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives

Heppt M, Gebhardt C, Hassel JC, Alter M, Gutzmer R, Leiter U, Berking C (2022)

Publication Type: Journal article, Review article

Publication year: 2022

Journal

Cancers MDPI

Book Volume: 14

Journal Issue: 19

DOI: 10.3390/cancers14194547

Abstract

Simple Summary Local therapies are no longer an option for locally advanced basal cell carcinoma. Abnormal activation of the hedgehog signaling pathway leads to uncontrolled tumor growth. Hedgehog pathway inhibitors are an effective treatment option for this kind of tumor. However, treatment-related toxicity under long-term treatment may lead to limitations in quality of life, and thus to therapy interruption or even discontinuation. This review summarizes pertinent treatment adjustments and novel therapeutic strategies for effective treatment of locally advanced basal cell carcinoma. The first-line therapy for locally advanced basal cell carcinoma (laBCC) is Hedgehog pathway inhibitors (HHIs), as they achieve good efficacy and duration of response. However, toxicity in the course of long-term treatment may lead to a decrease in the quality of life, and consequently to interruption or even discontinuation of therapy. As HHI therapy is a balancing act between effectiveness, adverse events, quality of life, and adherence, numerous successful treatment strategies have evolved, such as dose reduction and dose interruptions with on-off treatment schedules or interruptions with re-challenge after progression. As a small percentage of patients show primary or acquired resistance to HHIs, the inhibition of programmed cell death protein 1 (PD-1) has been approved as a second-line therapy, which may also be accompanied by immune-related toxicities and non-response. Thus, optimization of current treatment schedules, novel agents, and combination strategies are urgently needed for laBCC. Here, we narratively model the treatment sequence for patients with laBCC and summarize the current state of approved treatment regimens and therapeutic strategies to optimize the long-term management of laBCC.

Authors with CRIS profile

Markus Heppt Department of Dermatology Carola Berking Lehrstuhl für Haut- und Geschlechtskrankheiten

Involved external institutions

Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Ruhr-Universität Bochum (RUB) DE Germany (DE) Eberhard Karls Universität Tübingen DE Germany (DE)

How to cite

APA:

Heppt, M., Gebhardt, C., Hassel, J.C., Alter, M., Gutzmer, R., Leiter, U., & Berking, C. (2022). Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives. Cancers, 14(19). https://doi.org/10.3390/cancers14194547

MLA:

Heppt, Markus, et al. "Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives." Cancers 14.19 (2022).

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