Abstract
Basal cell carcinoma (BCC) is the most common malignancy worldwide, arising from non-keratinizing cells within the basal layer of the epidermis. The incidence of BCC continues to rise annually, increasing the burden of management of these carcinomas and the morbidity associated with their treatment. While surgical interventions such as Mohs micrographic surgery and surgical excision are the standard of care and yield the highest cure rates, the number of non-surgical interventions approved for the treatment of BCC continues to expand. We review various surgical and non-surgical approaches to the treatment of BCC, focusing on targeted molecular therapies that are approved for locally advanced or recurrent disease.
Highlights
Non-melanoma skin cancers (NMSCs), which include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most common cancers in Caucasians
In 2012, 5.4 million NMSCs were diagnosed in the US alone[2]
Incidence rates of BCC in the US have risen by approximately 2% per year[3], and there are significant increases among women and individuals younger than 40 years of age[3,4,5,6]
Summary
Non-melanoma skin cancers (NMSCs), which include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most common cancers in Caucasians. Similar response rates were seen in a subsequent open-label, two-cohort, multicenter study of 119 patients with advanced BCC who were poor candidates for surgical resection or radiotherapy They were treated with vismodegib 150 mg daily. Major disadvantages of radiation include multiple visits, lack of confirmation of histologic clearance, development of aggressive phenotypes in some recurrent tumors, poor long-term cosmesis with conventional radiotherapy, and high cost as compared with surgical treatments[107]. In a randomized trial comparing surgical excision with 2-mm margins versus radiation with brachytherapy, superficial x-ray therapy or conventional radiotherapy showed four-year recurrence rates of 0.7% in patients who underwent surgery versus 7.5% in those who underwent radiotherapy[108]. The patient demonstrated near complete resolution of metastatic disease within 4 months of treatment[118]
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