Advanced BCC: histological subtype and time to complete response may predict tumour recurrence

Histologic risk status at diagnosis and the time needed to achieve complete remission (CR) may influence the prospect of a relapse further down the line for patients with advanced basal cell carcinoma (BCC) treated with Hedgehog pathway inhibitor (HHI). Those with low-risk histology were less likely to relapse, as were those reaching CR in up to 8 months.

A retrospective multicentre study investigated patients with advanced BCC treated with HHI for factors linked to recurrence after CR [1]. Between 2016 and 2024, Dr Maria Mannino (Catholic University of the Sacred Heart, Italy) and colleagues included 106 adult patients who had received HHIs sonidegib (88.7%) or vismodegib (11.3%). The cohort’s mean age was 78 years, 35.8% were women and the median duration of HHI therapy was 18 months. Complete remission (CR) was achieved after a median of 8 months.

A BCC relapse after CR happened in 13.2% of the participants at a median of 12 months. High-risk histological subtypes (e.g. morpheiform, basosquamous, infiltrative, and micronodular) were more prevalent in the tumour recurrence arm (71.4%) versus the non-relapsing participants (28.3%). Consistent with this, further analyses identified having a low-risk subtype in the histology of BCC linked to a better chance of relapse-free survival with an odds ratio (OR) of 0.15 (95% CI 0.04–0.51; P=0.003) compared with a high-risk histology.

In addition, time to CR significantly influenced the risk of relapse (OR 1.07; 95% CI 1.01–1.15; P=0.04. Specifically, reaching CR in 8 months or less entailed a significantly higher probability of relapse-free survival (HR 0.14; 95% CI 0.047–0.43; P=0.0003).

All in all, this study identified histological risk features and time to CR as possible predictors of tumour recurrence after CR in advanced BCC. These findings may influence treatment decisions and follow-up strategies for patients with advanced BBC, receiving HHI therapy.

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   1. Mannino M. Advanced basal cell carcinoma: clinical and histological predictors of tumor recurrence after complete response on hedgehog inhibitors. EPS02.02, EADV Congress 2024, 25–28 September, Amsterdam, the Netherlands.

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Medical writing support provided by Karin Drooff, MPH



Posted on 30 September 202430 September 2024