Kathryn Roth
Western University
Canada
Title: Beyond the Scalpel- Management Options for Advanced Basal Cell Carcinoma
Biography
Biography: Kathryn Roth
Abstract
This symposium will offer a practical, case-based approach to the management options available for advanced basal cell carcinoma (BCC) skin lesions of the head and neck region. Discussion will include margin status and reconstructive options. Tumor size, poorly defined margins, the presence of perineural or vascular invasion and failed prior treatments are factors associated with poorer prognosis and a more aggressive phenotype. Increasing rates of immunosuppressive therapies and solid organ transplants confer higher risk of recurrent skin carcinoma. Aggressive or neglected tumour growth is seen in rare but unfortunate patients who may have medical contraindications for surgery or where resection may result in significant morbidity or deformity. Vismodegib is a novel, targeted systemic therapy indicated for advanced, unresectable BCC. An update regarding the hedge-hog signalling inhibition mechanism of action and the efficacy of vismodegib will be provided. Results from the SHH477g and STEVIE trials with vismodegib highlight the tolerable side effect profile and clinical utility for patients with basal cell nevus (Gorlin’s) syndrome. Future areas of study in the use of non-surgical options for patients with advanced BCC will be examined.