"Treatment options are focused on local control, including surgical techniques as curettage and electrodessication, cryosurgery , surgical excision, and Mohs micrographic surgery. Nonsurgical approaches include radiotherapy, topical injection therapy, and photodynamic therapy (Rubin et al. 2005). Mutations in genes associated with the sonic hedgehog (SHH) signaling pathway, as well as defects in repair genes or up-regulation of transcription factors have been implied in the development of BCC (Iwasaki et al. 2013). "
[Show abstract][Hide abstract] ABSTRACT: Multiple environmental and genetic factors are involved with the development of basal cell carcinomas (BCC), as well as with breast cancers. Tumor initiation and progression are often associated with genomic instability such as aneuploidies, and gains or losses of large chromosomal segments, known as copy number alterations (CNAs). CNAs have been successfully detected using the microarray comparative genomic hybridization technique (array-CGH) at high resolution. Data thus obtained are useful to identify specific genomic aberrations, to classify tumor stages, and to stratify subgroups of patients with different prognosis and clinical behaviors.
"Metastasis is rare with ,1% of cases progressing to this stage with a median time of 8 yr after the initial lesion forms. Local surgical excision and chemotherapy are the most common traditional therapies to treat BCC (Rubin et al. 2005). Surgical methods include curettage (scooping or scraping), electrodissection (burning), cryosurgery (freezing), surgical excision, and Mohs surgery ( progressive excision with real-time pathology). "
[Show abstract][Hide abstract] ABSTRACT: Basal cell carcinomas (BCCs) are very common epithelial cancers that depend on the Hedgehog pathway for tumor growth. Traditional therapies such as surgical excision are effective for most patients with sporadic BCC; however, better treatment options are needed for cosmetically sensitive or advanced and metastatic BCC. The first approved Hedgehog antagonist targeting the membrane receptor Smoothened, vismodegib, shows remarkable effectiveness on both syndromic and nonsyndromic BCCs. However, drug-resistant tumors frequently develop, illustrating the need for the development of next-generation Hedgehog antagonists targeting pathway components downstream from Smoothened. In this article, we will summarize available BCC treatment options and discuss the development of next-generation antagonists.
Cold Spring Harbor Perspectives in Medicine 07/2014; 4(7). DOI:10.1101/cshperspect.a013581 · 7.56 Impact Factor
"Basal cell carcinoma (BCC) is the most commonly diagnosed skin cancer. Although most BCCs are indolent , metastases occur in rare cases  . Because metastatic BCC (mBCC) is uncommon, its incidence and disease course are poorly characterised. "
[Show abstract][Hide abstract] ABSTRACT: This review provides a description of the epidemiology and survival outcomes for cases with metastatic basal cell carcinoma (mBCC) based on published reports (1981-2011).
A literature search (MEDLINE via PubMed) was conducted for mBCC case reports published in English: 1981-2011. There were 172 cases that met the following criteria: primary BCC located on skin, metastasis confirmed by pathology and metastasis not resulting from direct tumour spread. From these, 100 mBCC cases with explicit information on follow-up time were selected for analysis. Survival analysis was conducted using Kaplan-Meier methods.
Among 100 mBCC cases selected for analysis, including one case with Gorlin syndrome, 50% had regional metastases (RM) and 50% had distant metastases (DM). Cases with DM were younger at mBCC diagnosis (mean age, 58.0 versus 66.3years for RM; P=0.0013). Among 93 (of 100) cases with treatment information for metastatic disease, more DM cases received chemotherapy (36.2% versus 6.5% for RM), but more RM cases underwent surgery (87.0% versus 40.4% for DM). Among all 100 cases, median survival after mBCC diagnosis was 54months (95% confidence interval (CI), 24-72), with shorter survival in DM (24months; 95% CI, 12-35) versus RM cases (87months; 95% CI, 63-not evaluable).
Cases with RM and DM mBCC may have different clinical courses and outcomes. Based on published reports, DM cases were younger at mBCC diagnosis, with shorter median survival than RM cases. This study provides a historical context for emerging mBCC treatments.
European journal of cancer (Oxford, England: 1990) 01/2014; 50(4). DOI:10.1016/j.ejca.2013.12.013 · 4.82 Impact Factor
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