Basal cell carcinoma (BCC) is the most common malignancy of humans with an estimated 2 million new cases per year in the U.S. It is generally considered that BCC’s are caused, at least in part, by chronic excessive sun exposure over many years’ time. Various surgical techniques, topical chemotherapy creams, and radiation therapy easily cure the majority of these tumors. However, some BCC’s resist some or all of these treatments, recur, and cause local destruction of vital skin structures with ulcerations. A subset of these tumors may even metastasize to lymph nodes or other internal organs and cause death.
For the first time ever, a capsule provided substantial shrinkage and some cures of metastatic and locally advanced BCC. The FDA approved vismodegib (brand name Erivedge) in 2012. The drug is taken orally once daily. It works by blocking a signaling pathway implicated in the development of the skin cancer.
Vismodegib may also be valuable in the treatment of a genetic condition called the Basal Cell Nevus Syndrome in which patients begin developing numerous aggressive BCC’s at an early age. In clinical studies, the drug significantly reduced the size of existing BCC’s and prevented the development of new ones during treatment.
Mild to moderate side effects were common and consisted of muscle spasms, hair loss, taste alteration, weight loss, fatigue, nausea, and diarrhea. The drug can cause severe birth defects.
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