Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives
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 interrupti...
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| Format: | Article |
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MDPI AG
2022-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/19/4547 |
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| author | Markus V. Heppt Christoffer Gebhardt Jessica C. Hassel Mareike Alter Ralf Gutzmer Ulrike Leiter Carola Berking |
| author_facet | Markus V. Heppt Christoffer Gebhardt Jessica C. Hassel Mareike Alter Ralf Gutzmer Ulrike Leiter Carola Berking |
| author_sort | Markus V. Heppt |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T21:58:46Z |
| format | Article |
| id | doaj.art-82740b1b3e6045748246065e11f109da |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T21:58:46Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-82740b1b3e6045748246065e11f109da2023-11-23T19:52:41ZengMDPI AGCancers2072-66942022-09-011419454710.3390/cancers14194547Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future PerspectivesMarkus V. Heppt0Christoffer Gebhardt1Jessica C. Hassel2Mareike Alter3Ralf Gutzmer4Ulrike Leiter5Carola Berking6Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, GermanyDepartment of Dermatology and National Center for Tumor Diseases (NCT), University Hospital Heidelberg, 69120 Erlangen, GermanyDepartment of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum Campus Minden, 32423 Minden, GermanyDepartment of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum Campus Minden, 32423 Minden, GermanyDepartment of Dermatology, Eberhard-Karls-University Tuebingen, 72076 Tuebingen, GermanyDepartment of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, GermanyThe 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.https://www.mdpi.com/2072-6694/14/19/4547basal cell carcinomaHedgehog pathway inhibitorsimmunotherapyprogrammed cell death protein 1 inhibitor |
| spellingShingle | Markus V. Heppt Christoffer Gebhardt Jessica C. Hassel Mareike Alter Ralf Gutzmer Ulrike Leiter Carola Berking Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives Cancers basal cell carcinoma Hedgehog pathway inhibitors immunotherapy programmed cell death protein 1 inhibitor |
| title | Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives |
| title_full | Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives |
| title_fullStr | Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives |
| title_full_unstemmed | Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives |
| title_short | Long-Term Management of Advanced Basal Cell Carcinoma: Current Challenges and Future Perspectives |
| title_sort | long term management of advanced basal cell carcinoma current challenges and future perspectives |
| topic | basal cell carcinoma Hedgehog pathway inhibitors immunotherapy programmed cell death protein 1 inhibitor |
| url | https://www.mdpi.com/2072-6694/14/19/4547 |
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