Transforming Outcomes in Advanced Basal Cell Carcinoma: The Evolving Role of Systemic Therapy

Holterhues C, Vries E, Louwman MW, Koljenovic S, Nijsten T. Incidence and trends of cutaneous malignancies in the Netherlands, 1989-2005. J Invest Dermatol. 2010;130(7):1807–12.

Article  CAS  PubMed  Google Scholar 

Wang R, Chen Y, Shao X, Chen T, Zhong J, Ou Y, et al. Burden of skin cancer in older adults from 1990 to 2021 and modelled projection to 2050. JAMA Dermatol. 2025;161(7):715–22.

Article  PubMed  PubMed Central  Google Scholar 

Schreuder K, Hollestein L, Nijsten TEC, Wakkee M, Louwman MWJ. A nationwide study of the incidence and trends of first and multiple basal cell carcinomas in the Netherlands and prediction of future incidence. Br J Dermatol. 2022;186(3):476–84.

Article  CAS  PubMed  Google Scholar 

Dreier J, Cheng PF, Bogdan Alleman I, Gugger A, Hafner J, Tschopp A, et al. Basal cell carcinomas in a tertiary referral centre: a systematic analysis. Br J Dermatol. 2014;171(5):1066–72.

Article  CAS  PubMed  Google Scholar 

Goldenberg G, Karagiannis T, Palmer JB, Lotya J, O’Neill C, Kisa R, et al. Incidence and prevalence of basal cell carcinoma (BCC) and locally advanced BCC (LABCC) in a large commercially insured population in the United States: a retrospective cohort study. J Am Acad Dermatol. 2016;75(5):957–66.

Article  PubMed  Google Scholar 

Schmults CD, Blitzblau R, Aasi SZ, Alam M, Amini A, Bibee K, et al. Basal cell skin cancer, version 2.2024, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2023;21(11):1181–203.

Article  CAS  PubMed  Google Scholar 

Peris K, Fargnoli MC, Kaufmann R, Arenberger P, Bastholt L, Seguin NB, et al. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer. 2023;192:113254.

Article  PubMed  Google Scholar 

Di Nardo L, Pellegrini C, Di Stefani A, Ricci F, Fossati B, Del Regno L, et al. Molecular alterations in basal cell carcinoma subtypes. Sci Rep. 2021;11(1):13206.

Article  PubMed  PubMed Central  Google Scholar 

Goodman AM, Kato S, Cohen PR, Boichard A, Frampton G, Miller V, et al. Genomic landscape of advanced basal cell carcinoma: implications for precision treatment with targeted and immune therapies. Oncoimmunology. 2018;7(3):e1404217.

Article  PubMed  Google Scholar 

Carballo GB, Honorato JR, de Lopes GPF, Spohr T. A highlight on Sonic hedgehog pathway. Cell Commun Signal. 2018;16(1):11.

Article  PubMed  PubMed Central  Google Scholar 

Brinkhuizen T, van Geel M, Denil SL, De Meyer T, Kelleners-Smeets NW, Lohuis PJ, et al. Locally advanced basal cell carcinoma has a distinct methylation and transcriptomic profile. Exp Dermatol. 2016;25(4):316–8.

Article  PubMed  Google Scholar 

Krakowski AC, Hafeez F, Westheim A, Pan EY, Wilson M. Advanced basal cell carcinoma: what dermatologists need to know about diagnosis. J Am Acad Dermatol. 2022;86(6S):S1–13.

Article  PubMed  Google Scholar 

Verkouteren JAC, Ramdas KHR, Wakkee M, Nijsten T. Epidemiology of basal cell carcinoma: scholarly review. Br J Dermatol. 2017;177(2):359–72.

Article  CAS  PubMed  Google Scholar 

Lear JT, Corner C, Dziewulski P, Fife K, Ross GL, Varma S, et al. Challenges and new horizons in the management of advanced basal cell carcinoma: a UK perspective. Br J Cancer. 2014;111(8):1476–81.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Legrand A, Quintard B, Garrouteigt C, Beylot-Barry M, Broc G. From neglect to earlier diagnosis: a qualitative meta-synthesis of psycho-social factors associated with consultation delay in advanced basal cell carcinoma. Psychol Health Med. 2022;27(8):1793–804.

Article  CAS  PubMed  Google Scholar 

Randle HW, Roenigk RK, Brodland DG. Giant basal cell carcinoma (T3). Who is at risk? Cancer. 1993;72(5):1624–30.

Article  CAS  PubMed  Google Scholar 

Zwanenburg A, Van Houdt WJ, Schrijver AM, Schreuder WH, Wouters M, Plasmeijer EI. Clinical features and outcomes of locally advanced and metastatic basal cell carcinoma. Acta Derm Venereol. 2025;105:adv43240.

Article  PubMed  PubMed Central  Google Scholar 

Casey D, Demko S, Shord S, Zhao H, Chen H, He K, et al. FDA approval summary: sonidegib for locally advanced basal cell carcinoma. Clin Cancer Res. 2017;23(10):2377–81.

Article  CAS  PubMed  Google Scholar 

Sekulic A, Migden MR, Oro AE, Dirix L, Lewis KD, Hainsworth JD, et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med. 2012;366(23):2171–9.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lewis KD, Peris K, Sekulic A, Stratigos AJ, Dunn L, Eroglu Z, et al. Final analysis of phase II results with cemiplimab in metastatic basal cell carcinoma after hedgehog pathway inhibitors. Ann Oncol. 2024;35(2):221–8.

Article  CAS  PubMed  Google Scholar 

Stratigos AJ, Sekulic A, Peris K, Bechter O, Prey S, Lewis KD, et al. Phase 2 open-label, multicenter, single-arm study of cemiplimab in patients with locally advanced basal cell carcinoma after hedgehog inhibitor therapy: extended follow-up. J Am Acad Dermatol. 2024;90(2):414–8.

Article  CAS  PubMed  Google Scholar 

Verkouteren BJA, Wakkee M, Reyners AKL, Nelemans P, Aarts MJB, Racz E, et al. Eight years of experience with vismodegib for advanced and multiple basal cell carcinoma patients in the Netherlands: a retrospective cohort study. Br J Cancer. 2021;124(7):1199–206.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jacobsen AA, Aldahan AS, Hughes OB, Shah VV, Strasswimmer J. Hedgehog pathway inhibitor therapy for locally advanced and metastatic basal cell carcinoma: a systematic review and pooled analysis of interventional studies. JAMA Dermatol. 2016;152(7):816–24.

Article  PubMed  Google Scholar 

Ramelyte E, Restivo G, Mannino M, Levesque MP, Dummer R. Advances in the drug management of basal cell carcinoma. Expert Opin Pharmacother. 2022;23(5):573–82.

Article  CAS  PubMed  Google Scholar 

Verdonschot RG, Dilles T, Cahir C, De Graef M, Holis RV, Fryden J, et al. To Include or Not to Include? A prescription from the pharmacy on how to use active learning assisted screening in systematic reviews. medRxiv. 2025:2025.09.26.25336705.

Sekulic A, Migden MR, Basset-Seguin N, Garbe C, Gesierich A, Lao CD, et al. Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: final update of the pivotal ERIVANCE BCC study. BMC Cancer. 2017;17(1):332.

Article  PubMed  PubMed Central  Google Scholar 

Dummer R, Guminksi A, Gutzmer R, Lear JT, Lewis KD, Chang ALS, et al. Long-term efficacy and safety of sonidegib in patients with advanced basal cell carcinoma: 42-month analysis of the phase II randomized, double-blind BOLT study. Br J Dermatol. 2020;182(6):1369–78.

Article  CAS  PubMed  Google Scholar 

Venturi F, Zuccaro B, Perillo G, Cecchi G, Gaeta A, Gandini S, et al. Management of advanced basal cell carcinoma with hedgehog inhibitors: a real-world prospective comparative study. Clin Exp Dermatol. 2025;51:60–7.

Article  PubMed  Google Scholar 

Mannino M, Piccerillo A, Fabbrocini G, Quaglino P, Argenziano G, Dika E, et al. Clinical characteristics of an Italian patient population with advanced BCC and real-life evaluation of hedgehog pathway inhibitor safety and effectiveness. Dermatology. 2023;239(6):868–76.

Article  CAS  PubMed  Google Scholar 

Valenti M, Di Giulio S, Carugno A, Frascione P, Marzano AV, Mercuri SR, et al. Real-world experience with vismodegib and sonidegib in advanced basal cell carcinoma: a multicenter Italian study. Dermatol Rep. 2025;17(3):10196.

Article  CAS  Google Scholar 

Gurbuz M, Dogan I, Akkus E, Ermis H, Utkan G, Vatansever S, et al. Efficacy and tolerability of vismodegib treatment in locally advanced and metastatic basal cell carcinoma: retrospective real-life data. Dermatol Ther. 2021;34(6):e15122.

Article  PubMed  Google Scholar 

Comments (0)

No login
gif