title: [Locally advanced basal-cell carcinoma: Combined alternative treatments beyond surgery].
abstract: The vismodegib, inhibitor of the hedgehog signaling pathway, is a new therapeutic option in locally advanced BCC when surgery or radiotherapy are inappropriate. If the response rate is high with rapid and sustained efficacy, complete responses are rare. Furthermore, the common side effects may limit continuous and prolonged treatment and lead to discuss sequential treatments. We report two cases that illustrate the severity of LaCBC, tumors neglected by patients and their families limiting therapeutic choice especially surgery that become impossible and for which vismodegib is indicated. These observations illustrate the possible interest of radiotherapy in combination or after tumor debulking by vismodegib. Vismodegib must be known by surgeons for LaCBC, mainly as an alternative beyond surgery but also as a possible neoadjuvant treatment to surgery that have to be evaluated.
authors.affiliation: Service de dermatologie, CHU de Bordeaux, hôpital Haut-Lévêque, université de Bordeaux, avenue de Magellan, 33604 Pessac, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Amici
authors.affiliation: Service de dermatologie, CHU de Bordeaux, hôpital Haut-Lévêque, université de Bordeaux, avenue de Magellan, 33604 Pessac, France. Electronic address: marie.beylot-barry@chu-bordeaux.fr.
authors.forename: M
authors.initials: M
authors.lastname: Beylot-Barry
mesh_terms: D000328:Adult; D000368:Aged; D000813:Anilides / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011725:Pyridines / Q000627:therapeutic use*; D018714:Radiotherapy, Adjuvant; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000813:Anilides; D000970:Antineoplastic Agents; C538724:HhAntag691; D011725:Pyridines
keywords: Advanced non-resectable basal-cell carcinoma; Carcinomes basocellulaires avancés; Hedgehog pathway inhibitor; Inhibiteur hedgehog; Radiotherapy; Radiothérapie; Vismodegib