title: Emergence of chemoresistance in a metastatic basal cell carcinoma patient after complete response to hedgehog pathway inhibitor vismodegib (GDC-0449).
abstract: Vismodegib (GDC-0449, Genentech, USA), a small molecule inhibitor of the Hedgehog signalling pathway, has potent anti-tumour activity in advanced basal cell carcinoma (BCC). We report a case of a 67-year-old Australian man with metastatic BCC including pulmonary disease with malignant effusion who showed a dramatic complete response to vismodegib but subsequently experienced a recurrence of pulmonary disease, indicative of chemoresistance to vismodegib. This case is the first to illustrate chemoresistance in a patient with metastatic BCC, and demonstrates the need for closely monitoring metastatic BCC patients even after an apparently complete response.
authors.affiliation: Victorian Melanoma Service, Melbourne, Victoria, Australia.
authors.forename: Rowena E
authors.initials: RE
authors.lastname: Meani
authors.forename: Shueh-Wen
authors.initials: SW
authors.lastname: Lim
authors.forename: Anne Lynn S
authors.initials: AL
authors.lastname: Chang
authors.forename: John W
authors.initials: JW
authors.lastname: Kelly
mesh_terms: D000368:Aged; D000813:Anilides / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000556:secondary; D019008:Drug Resistance, Neoplasm; D053823:Hedgehog Proteins / Q000037:antagonists & inhibitors; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D011725:Pyridines / Q000627:therapeutic use*; D012272:Ribs; D015398:Signal Transduction / Q000187:drug effects; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000813:Anilides; D000970:Antineoplastic Agents; D053823:Hedgehog Proteins; C538724:HhAntag691; D011725:Pyridines
keywords: Hedgehog inhibitor; advanced BCC; basal cell carcinoma (BCC); chemoresistance; metastatic BCC; secondary resistance; vismodegib