WEDNESDAY, Oct. 25, 2023 -- For patients with basal cell carcinoma (BCC) unable to tolerate the traditional vismodegib dosing regimen, an alternative regimen provides therapeutic effects without intolerable side effects, according to a research letter published in the September issue of SKIN.

Timothy Orlowski, M.D., from the University of Alabama at Birmingham, and colleagues conducted a retrospective review of side effects, safety, and efficacy of an alternative vismodegib dosing pattern in six patients from a single institution who were unable to tolerate the traditional dosing regimen. The patients were prescribed vismodegib 150 mg daily for seven days, followed by a 21-day drug holiday.

The researchers found that improvement or resolution of adverse events was reported by all patients on this alternative treatment regimen; patients continued on this regimen for an average of 30.7 months. No new BCC development was seen for four patients, and their existing BCCs shrunk in size. A single BCC was developed by one patient with basal cell nevus syndrome 24 months into treatment; another patient developed a single BCC during a drug holiday for radiation therapy of lung squamous cell carcinoma.

"Our alternative long-term dosing schedule of vismodegib 150 mg daily for seven days followed by a 21-day drug holiday may provide therapeutic effects without intolerable side effects," the authors write. "It's not clear what maintenance schedule of vismodegib is ideal for patients requiring long-term treatment; however, future prospective studies may elucidate a regimen that minimizes both BCC burden and adverse effects."