Development of squamous cell carcinoma into basal cell carcinoma under treatment with Vismodegib

Authors


  • Conflicts of interest

    Member of a board Roche.

  • Funding sources

    None reported. We report three cases of SCC appeared into BCC in vismodegib-treated patients.

  • [Correction was added on 15 Aug 2014 after first online publication. Conflicts of interest has been updated.]

Abstract

Background

Basal cell carcinoma (BCC) is the most common cancer in humans. Vismodegib, a Hedgehog pathway inhibitor, has proved its effectiveness in treating non-resectable advanced BCC.

Aim

However, its action on squamous cell carcinoma (SCC) is unknown. We present three SCC cases developed into BCC in vismodegib-treated patients.

Material and methods

We have described three cases of patients developing SCC during treatment by vismodegib for BCC.

Results

Patient 1 was treated with vismodegib for five facial BCC. Due to the progression of one of the lesions at month 3 (M3), a biopsy was performed and showed SCC. Patient 2 was treated with vismodegib for a large facial BCC. A biopsy was performed at M2 on a BCC area not responding to treatment and showed SCC. Patient 3 was treated with vismodegib for a BCC on the nose. Due to vismodegib ineffectiveness, a biopsy was performed and showed SCC.

Discussion

Two similar cases have been described in the literature. This could be due to the appearance of the squamous contingent of a metatypical BCC or to the squamous differentiation of stem cells through inhibition of the hedgehog pathway.

Conclusion

In practice, any dissociated response of a BCC to vismodegib should be biopsied.

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