In a French retrospective study reported in the Journal of Clinical Oncology, Herms et al found that long-term response is frequently maintained in patients discontinuing vismodegib after complete remission of locally advanced basal cell carcinoma, and that responses can be achieved with vismodegib retreatment after relapse.
Study Details
The study involved 116 patients with basal cell carcinoma from nine French oncodermatology units who achieved complete remission on vismodegib and discontinued treatment between March 2012 and January 2016. Charts were reviewed through June 2016. The primary objective was to evaluate relapse-free survival.
Relapse-Free Survival
KEY POINTS
- Median relapse-free survival after vismodegib discontinuation was 18.4 months, with a 36-month rate of 35.4%.
- Among patients retreated with vismodegib after relapse, 85% had objective response.
Among all patients, median relapse-free survival was 18.4 months, with 36-month rates of 35.4% for the total population and 40.0% for the 98 patients without Gorlin syndrome, a condition that increases the risk of developing various cancerous and noncancerous tumors. Median overall survival was not reached, with a 36-month rate of 85% being observed.
The cumulative incidence of relapse at 36 months was 59.0%. Among patients with relapse, relapse was focal in 35 patients (65%) and multifocal in 19 (35%). All patients with Gorlin syndrome experienced relapse or developed a new basal cell carcinoma during follow-up. On multivariate analysis, localization of disease to the limbs and trunk was the only factor independently associated with increased risk of relapse (hazard ratio = 2.77, P = .019).
Retreatment with vismodegib in 27 patients with relapse during follow-up resulted in objective response in 23 (85%) and complete response in 10 (37%). Among 54 patients with relapse during follow-up, 24 (42%) were eligible for surgery.
The investigators concluded, “Long-term response after vismodegib discontinuation is frequent. Most patients who experience a relapse still respond to vismodegib rechallenge.”
Nicole Basset-Seguin, MD, PhD, of the Unité d’Onco-Dermatologie, Hôpital Saint-Louis, Paris, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by Roche Laboratories. For full disclosures of the study authors, visit jco.ascopubs.org.
