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  1. Article ; Online: Characterization of Serous Retinopathy Associated with Cobimetinib: Integrated Safety Analysis of Four Studies.

    Barteselli, Giulio / Goodman, Grant R / Patel, Yogesh / Caro, Ivor / Xue, Cloris / McCallum, Samuel

    Drug safety

    2022  Volume 45, Issue 12, Page(s) 1491–1499

    Abstract: Introduction and objective: Serous retinopathy can be associated with MEK inhibitors, including cobimetinib. We present results of an integrated safety analysis to further characterize ocular functional and structural changes due to serous retinopathy.!# ...

    Abstract Introduction and objective: Serous retinopathy can be associated with MEK inhibitors, including cobimetinib. We present results of an integrated safety analysis to further characterize ocular functional and structural changes due to serous retinopathy.
    Methods: Four studies evaluating cobimetinib at the approved dose and schedule in combination with other oncology drugs were included. Study CO39721 incorporated standardized ophthalmologic assessments to fully characterize serous retinopathy events over time and was the primary study for analysis. Supporting information was provided by studies GO28141, WO29479, and GO30182.
    Results: In total, 655 patients received one or more doses of cobimetinib and comprised the safety-evaluable population. Overall, 117 patients (17.9%) had one or more serous retinopathy events, 24 (3.7%) had two or more events, and four (0.6%) had three or more events. Grade 3 events occurred in < 2.5% of patients. In CO39721, the median time to onset was 15 days (range 7-111); median time to resolution of first occurrence was 26 days (range 6-591 + days). Twelve of 25 patients (48.0%) recovered without a dose modification and 4/25 (16.0%) were recovered/recovering following a dose modification. The most frequent presentation of serous retinopathy was focal subretinal fluid on optical coherence tomography (62.8% of cases); in some instances (25.7% of cases), subretinal fluid was multifocal. There was no loss of visual function or visual acuity at serous retinopathy onset or resolution.
    Conclusions: Results from this integrated safety analysis indicate that cobimetinib-associated serous retinopathy can be managed with or without a dose modification of cobimetinib at the discretion of the treating physician. No visual loss or permanent retinal damage was identified on comprehensive ophthalmologic assessments.
    Clinical trial registration: ClinicalTrials.gov identifiers: NCT03178851, NCT01689519, NCT02322814, and NCT02788279.
    MeSH term(s) Humans ; Azetidines/adverse effects ; Piperidines/adverse effects ; Protein Kinase Inhibitors/adverse effects ; Retinal Diseases/drug therapy
    Chemical Substances Azetidines ; cobimetinib (ER29L26N1X) ; Piperidines ; Protein Kinase Inhibitors
    Language English
    Publishing date 2022-10-30
    Publishing country New Zealand
    Document type Clinical Trial ; Journal Article
    ZDB-ID 1018059-x
    ISSN 1179-1942 ; 0114-5916
    ISSN (online) 1179-1942
    ISSN 0114-5916
    DOI 10.1007/s40264-022-01248-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Vismodegib and the Hedgehog Pathway Inhibitors: A Historical Perspective to Current Clinical Application.

    Tang, Jennifer C / Hanke, C William / Caro, Ivor

    Journal of drugs in dermatology : JDD

    2018  Volume 17, Issue 5, Page(s) 506–508

    Abstract: Vismodegib (Erivedge, Genentech-Roche) is the first in class of Hedgehog pathway inhibitors approved for treatment of metastatic basal cell carcinoma (BCC), or locally advanced BCC that has recurred after surgery or is not amenable to surgery or ... ...

    Abstract Vismodegib (Erivedge, Genentech-Roche) is the first in class of Hedgehog pathway inhibitors approved for treatment of metastatic basal cell carcinoma (BCC), or locally advanced BCC that has recurred after surgery or is not amenable to surgery or radiation. Its path to discovery has been unique and traces its origin to corn lilies, sheep, Drosophila flies, and the Hedgehog signaling pathway. J Drugs Dermatol. 2018;17(5):506-508.
    MeSH term(s) Anilides/administration & dosage ; Anilides/history ; Anilides/therapeutic use ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/history ; Antineoplastic Agents/therapeutic use ; Carcinoma, Basal Cell/drug therapy ; Carcinoma, Basal Cell/secondary ; History, 20th Century ; History, 21st Century ; Humans ; Neoplasm Metastasis ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/secondary ; Pyridines/administration & dosage ; Pyridines/history ; Pyridines/therapeutic use ; Skin Neoplasms/drug therapy ; Skin Neoplasms/pathology ; United States
    Chemical Substances Anilides ; Antineoplastic Agents ; HhAntag691 ; Pyridines
    Language English
    Publishing date 2018-05-09
    Publishing country United States
    Document type Historical Article ; Journal Article
    ZDB-ID 2145090-0
    ISSN 1545-9616
    ISSN 1545-9616
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  3. Article ; Online: Elevated Levels of

    Lu, William / Burton, Luciana / Larkin, James / Chapman, Paul B / Ascierto, Paolo A / Ribas, Antoni / Robert, Caroline / Sosman, Jeffrey A / McArthur, Grant A / Chang, Ilsung / Caro, Ivor / Penuel, Elicia / Yan, Yibing / Wongchenko, Matthew J

    JCO precision oncology

    2022  Volume 2, Page(s) 1–17

    Abstract: Purpose: We performed a retrospective exploratory analysis to evaluate the prognostic and predictive effect of two circulating biomarkers, : Materials and methods: This study evaluated patients from BRIM-3, a phase III trial comparing vemurafenib and ...

    Abstract Purpose: We performed a retrospective exploratory analysis to evaluate the prognostic and predictive effect of two circulating biomarkers,
    Materials and methods: This study evaluated patients from BRIM-3, a phase III trial comparing vemurafenib and dacarbazine in 675 patients with
    Results: Patients with elevated levels of baseline
    Conclusion: Here, we report that BRIM-3 patients with high levels of ctDNA and cHGF have worse OS regardless of treatment and that these factors are independent prognostic markers for metastatic melanoma.
    Language English
    Publishing date 2022-01-27
    Publishing country United States
    Document type Journal Article
    ISSN 2473-4284
    ISSN (online) 2473-4284
    DOI 10.1200/PO.17.00168
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: First-line atezolizumab monotherapy in patients with advanced BRAF

    de Azevedo, Sergio Jobim / de Melo, Andreia Cristina / Roberts, Louise / Caro, Ivor / Xue, Cloris / Wainstein, Alberto

    Pigment cell & melanoma research

    2021  Volume 34, Issue 5, Page(s) 973–977

    Abstract: Anti-programmed death-1 agents are an established option for advanced melanoma, but the anti-programmed death-ligand 1 (anti-PD-L1) antibody atezolizumab, an agent approved for the treatment of multiple solid tumors, was not previously evaluated. This ... ...

    Abstract Anti-programmed death-1 agents are an established option for advanced melanoma, but the anti-programmed death-ligand 1 (anti-PD-L1) antibody atezolizumab, an agent approved for the treatment of multiple solid tumors, was not previously evaluated. This phase 1b study cohort (NCT03178851; cohort C) evaluated first-line atezolizumab 1,200 mg every 3 weeks in adults with BRAF
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Humanized/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Male ; Melanoma/drug therapy ; Melanoma/genetics ; Melanoma/metabolism ; Melanoma/mortality ; Middle Aged ; Progression-Free Survival ; Proto-Oncogene Proteins B-raf/genetics ; Proto-Oncogene Proteins B-raf/metabolism ; Skin Neoplasms/drug therapy ; Skin Neoplasms/genetics ; Skin Neoplasms/metabolism ; Skin Neoplasms/mortality ; Survival Rate
    Chemical Substances Antibodies, Monoclonal, Humanized ; atezolizumab (52CMI0WC3Y) ; BRAF protein, human (EC 2.7.11.1) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1)
    Language English
    Publishing date 2021-02-15
    Publishing country England
    Document type Clinical Trial, Phase I ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2409570-9
    ISSN 1755-148X ; 1600-0749 ; 0893-5785 ; 1755-1471
    ISSN (online) 1755-148X ; 1600-0749
    ISSN 0893-5785 ; 1755-1471
    DOI 10.1111/pcmr.12960
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Phase 1b study of cobimetinib plus atezolizumab in patients with advanced BRAF

    Sandhu, Shahneen / Atkinson, Victoria / Cao, Maria González / Medina, Theresa / Rivas, Ainara Soria / Menzies, Alexander M / Caro, Ivor / Roberts, Louise / Song, Yuyao / Yan, Yibing / Guo, Yu / Xue, Cloris / Long, Georgina V

    European journal of cancer (Oxford, England : 1990)

    2022  Volume 178, Page(s) 180–190

    Abstract: Objective: To evaluate the efficacy and safety of cobimetinib plus atezolizumab in the treatment of patients with advanced BRAF: Patients and methods: This phase 1b, open-label, international multicentre study enrolled 3 cohorts. Herein, we report on ...

    Abstract Objective: To evaluate the efficacy and safety of cobimetinib plus atezolizumab in the treatment of patients with advanced BRAF
    Patients and methods: This phase 1b, open-label, international multicentre study enrolled 3 cohorts. Herein, we report on patients in cohorts A and B who had progressed on prior anti‒PD-1 therapy. Patients in cohort A received cobimetinib 60 mg once daily for 21 days followed by a 7-day break and concurrent intravenous atezolizumab 840 mg every 2 weeks. Patients in cohort B received the same dosing regimen as cohort A except for cycle 1 in which patients received cobimetinib only for the first 14 days prior to initiation of atezolizumab on cycle 1 day 15. Coprimary end-points were objective response rate and disease control rate. Secondary end-points were duration of response, progression free survival and overall survival.
    Results: Between 19th June 2017 and 12th December 2018, 103 patients were enrolled. Median follow-up was 6.9 months (interquartile range, 4.8-10.1 months); objective response rate was 14.6% and disease control rate was 38.8% (95% confidence interval, 29.39-48.94). The median duration of response, progression-free survival and overall survival was 12.7 months, 3.8 months and 14.7 months, respectively. The most common adverse events were diarrhoea (75/103; 72.8%), dermatitis acneiform (57/103; 55.3%) and nausea (52/103; 50.5%). Thirty-four patients (33.0%) died: 33 (91.7%) due to progressive disease and one (1%) due to treatment-related oesophagitis.
    Conclusions: Combination therapy with cobimetinib and atezolizumab in patients with advanced BRAF
    Clinical trial registration: This study is registered with ClinicalTrials.gov; NCT03178851.
    MeSH term(s) Humans ; Proto-Oncogene Proteins B-raf/genetics ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Mutation ; Melanoma/drug therapy ; Melanoma/genetics
    Chemical Substances cobimetinib (ER29L26N1X) ; atezolizumab (52CMI0WC3Y) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; BRAF protein, human (EC 2.7.11.1)
    Language English
    Publishing date 2022-11-02
    Publishing country England
    Document type Multicenter Study ; Clinical Trial, Phase I ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 82061-1
    ISSN 1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
    ISSN (online) 1879-0852
    ISSN 0277-5379 ; 0959-8049 ; 0964-1947
    DOI 10.1016/j.ejca.2022.10.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: The role of the hedgehog signaling pathway in the development of basal cell carcinoma and opportunities for treatment.

    Caro, Ivor / Low, Jennifer A

    Clinical cancer research : an official journal of the American Association for Cancer Research

    2010  Volume 16, Issue 13, Page(s) 3335–3339

    Abstract: The hedgehog (Hh) signaling pathway plays an important role in embryogenesis across multiple species. Its activity is reduced or absent in adult organisms. However, activation of the pathway has been shown to be a factor in the development of a number of ...

    Abstract The hedgehog (Hh) signaling pathway plays an important role in embryogenesis across multiple species. Its activity is reduced or absent in adult organisms. However, activation of the pathway has been shown to be a factor in the development of a number of human malignancies and inhibition of the pathway is being investigated as a potential treatment for multiple cancers. The most extensively investigated and best characterized is basal cell carcinoma (BCC), which occurs in both an inherited form (basal cell nevus syndrome or Gorlin's syndrome) and a sporadic form. Sporadic BCCs are the most common human malignancy. There is recent data available on the use of a small molecule inhibitor of the pathway in BCC.
    MeSH term(s) Basal Cell Nevus Syndrome/metabolism ; Carcinoma, Basal Cell/metabolism ; Hedgehog Proteins/metabolism ; Hedgehog Proteins/physiology ; Humans ; Ligands ; Receptors, G-Protein-Coupled/metabolism ; Signal Transduction ; Skin Neoplasms/metabolism ; Smoothened Receptor
    Chemical Substances Hedgehog Proteins ; Ligands ; Receptors, G-Protein-Coupled ; SMO protein, human ; Smoothened Receptor
    Language English
    Publishing date 2010-07-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1225457-5
    ISSN 1557-3265 ; 1078-0432
    ISSN (online) 1557-3265
    ISSN 1078-0432
    DOI 10.1158/1078-0432.CCR-09-2570
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Overall survival with first-line atezolizumab in combination with vemurafenib and cobimetinib in BRAF

    Ascierto, Paolo A / Stroyakovskiy, Daniil / Gogas, Helen / Robert, Caroline / Lewis, Karl / Protsenko, Svetlana / Pereira, Rodrigo P / Eigentler, Thomas / Rutkowski, Piotr / Demidov, Lev / Zhukova, Natalia / Schachter, Jacob / Yan, Yibing / Caro, Ivor / Hertig, Christian / Xue, Cloris / Kusters, Lieke / McArthur, Grant A / Gutzmer, Ralf

    The Lancet. Oncology

    2022  Volume 24, Issue 1, Page(s) 33–44

    Abstract: Background: Primary analysis of the phase 3 IMspire150 study showed improved investigator-assessed progression-free survival with first-line atezolizumab, vemurafenib, and cobimetinib (atezolizumab group) versus placebo, vemurafenib, and cobimetinib ( ... ...

    Abstract Background: Primary analysis of the phase 3 IMspire150 study showed improved investigator-assessed progression-free survival with first-line atezolizumab, vemurafenib, and cobimetinib (atezolizumab group) versus placebo, vemurafenib, and cobimetinib (control group) in patients with BRAF
    Methods: The multicentre, double-blind, placebo-controlled, randomised, phase 3 IMspire150 study was done at 108 academic and community hospitals in 20 countries. Patients aged 18 years or older with previously untreated unresectable stage IIIc or stage IV melanoma and an Eastern Cooperative Oncology Group performance status of 0 or 1 were eligible for inclusion. Patients were randomly assigned (1:1) to receive either atezolizumab (840 mg intravenously on day 1 and 15) or placebo plus vemurafenib (960 mg or 720 mg twice daily orally) and cobimetinib (60 mg once daily orally; 21 days on and 7 days off) in 28-day cycles. Atezolizumab and placebo were added to treatment regimens from cycle two onwards. Randomisation was done centrally (Durham, NC, USA) based on a permuted block randomisation scheme (block size of 4) using an interactive web-based response system and was stratified by geographical region and baseline lactate dehydrogenase concentration. Overall survival was analysed in the intention-to-treat population and safety was analysed in all patients who received at least one dose of study drug according to actual treatment received. The primary endpoint was investigator-assessed progression-free survival, which was previously reported. Here, we report the second, prespecified, interim overall survival analysis, which was planned after about 270 overall survival events had occurred. The trial is ongoing, but is no longer enrolling patients, and it is registered with ClinicalTrials.gov, NCT02908672.
    Findings: Between Jan 13, 2017, and April 26, 2018, 514 patients (median age 54 years [IQR 43-63]; 299 [58%] men and 215 [42%] women) were enrolled in the trial and randomly assigned to the atezolizumab group (256 [50%] patients) or the control group (258 [50%] patients). At the data cutoff (Sept 8, 2021), 273 patients had died (126 in the atezolizumab group and 147 in the control group). Median follow-up was 29·1 months (IQR 10·1-45·4) for the atezolizumab group versus 22·8 months (10·6-44·1) for the control group. Median overall survival was 39·0 months (95% CI 29·9-not estimable) in the atezolizumab group versus 25·8 months (22·0-34·6) in the control group (HR 0·84 [95% CI 0·66-1·06]; p=0·14). The most common adverse events of any grade in the atezolizumab group were blood creatine phosphokinase increased (123 [53%] of 231 patients), diarrhoea (116 [50%]), and pyrexia (115 [50%]). The most common adverse events of any grade in the control group were diarrhoea (157 [56%] of 280 patients), blood creatine phosphokinase increased (135 [48%]), and rash (119 [43%]). The most common grade 3-4 adverse events were increased lipase (54 [23%] of 231 patients in the atezolizumab group vs 62 [22%] of 280 patients in the control group), increased blood creatine phosphokinase (51 [22%] vs 50 [18%]), and increased alanine aminotransferase (32 [14%] vs 26 [9%]). Serious adverse events were reported in 112 (48%) patients in the atezolizumab group and 117 (42%) patients in the control group. Grade 5 adverse events were reported in eight (3%) patients in the atezolizumab group versus six (2%) patients in the control group. Two grade 5 adverse events (hepatitis fulminant and hepatic failure) in the atezolizumab group were considered to be associated with the triplet combination, and one event in the control group (pulmonary haemorrhage) was considered to be associated with cobimetinib.
    Interpretation: Additional follow-up of the IMspire150 trial showed that overall survival was not significantly improved with atezolizumab, vemurafenib, and cobimetinib compared with placebo, vemurafenib, and cobimetinib in patients with BRAF
    Funding: F Hoffmann-La Roche.
    MeSH term(s) Male ; Humans ; Female ; Middle Aged ; Vemurafenib/adverse effects ; Proto-Oncogene Proteins B-raf/genetics ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Melanoma/drug therapy ; Melanoma/genetics ; Mutation ; Double-Blind Method
    Chemical Substances Vemurafenib (207SMY3FQT) ; atezolizumab (52CMI0WC3Y) ; cobimetinib (ER29L26N1X) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; BRAF protein, human (EC 2.7.11.1)
    Language English
    Publishing date 2022-11-29
    Publishing country England
    Document type Randomized Controlled Trial ; Multicenter Study ; Clinical Trial, Phase III ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(22)00687-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Vismodegib Efficacy in Advanced Basal Cell Carcinoma Maintained with 8-Week Dose Interruptions: A Model-Based Evaluation.

    Chanu, Pascal / Musib, Luna / Wang, Xin / Cheeti, Sravanthi / Girish, Sandhya / Bruno, Rene / Lu, Tong / Reddy, Josina / Jin, Jin Y / Caro, Ivor

    The Journal of investigative dermatology

    2020  Volume 141, Issue 4, Page(s) 930–933

    MeSH term(s) Administration, Oral ; Aged ; Aged, 80 and over ; Anilides/administration & dosage ; Anilides/adverse effects ; Anilides/pharmacokinetics ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/pharmacokinetics ; Carcinoma, Basal Cell/diagnosis ; Carcinoma, Basal Cell/drug therapy ; Carcinoma, Basal Cell/pathology ; Computer Simulation ; Datasets as Topic ; Drug Administration Schedule ; Female ; Humans ; Male ; Middle Aged ; Models, Biological ; Neoplasm Staging ; Pyridines/administration & dosage ; Pyridines/adverse effects ; Pyridines/pharmacokinetics ; Skin/drug effects ; Skin/pathology ; Skin Neoplasms/diagnosis ; Skin Neoplasms/drug therapy ; Skin Neoplasms/pathology ; Treatment Outcome ; Tumor Burden/drug effects
    Chemical Substances Anilides ; Antineoplastic Agents ; HhAntag691 ; Pyridines
    Language English
    Publishing date 2020-09-22
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't ; Validation Study
    ZDB-ID 80136-7
    ISSN 1523-1747 ; 0022-202X
    ISSN (online) 1523-1747
    ISSN 0022-202X
    DOI 10.1016/j.jid.2020.07.036
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  9. Article: Vismodegib Use in Clinical Practice: Analysis of a United States Medical Claims Database.

    Hanke, C William / Mhatre, Shivani K / Oliveri, David / Zivkovic, Marko / Caro, Ivor / Bergström, Daniel / Dawson, Keith / Sima, Camelia S

    Journal of drugs in dermatology : JDD

    2018  Volume 17, Issue 2, Page(s) 143–148

    Abstract: Background: Information is limited on the use of vismodegib for treatment of advanced basal cell carcinoma beyond the setting of clinical trials.: Objective: To investigate the treatment patterns and characteristics of patients treated with ... ...

    Abstract Background: Information is limited on the use of vismodegib for treatment of advanced basal cell carcinoma beyond the setting of clinical trials.
    Objective: To investigate the treatment patterns and characteristics of patients treated with vismodegib in clinical practice.
    Methods: A longitudinal, retrospective cohort study was undertaken using data from a US commercial insurance claims (Truven Health Analytics MarketScan) database. Eligible patients were ≥18 years of age, with ≥1 claim for vismodegib from January 2012 to December 2015.
    Results: A total of 321 patients were included in the analysis. Approximately 20% of the patients took 1 or more treatment breaks of ≥ 30 days each before treatment discontinuation. Median duration of vismodegib treatment before the first treatment break and discontinuation was 4.0 and 5.5 months, respectively. Older age ( > 65 years) and absence of Gorlin syndrome were associated with increased risk for treatment interruption or discontinuation. Overall, 47% and 36% of patients underwent surgery or radiotherapy within the 6 months before and after vismodegib initiation, respectively.
    Conclusions: Real-world evidence indicates that vismodegib is being used in clinical practice as part of combination treatment strategies. J Drugs Dermatol. 2018;17(2):143-148.
    MeSH term(s) Aged ; Anilides/therapeutic use ; Carcinoma, Basal Cell/drug therapy ; Carcinoma, Basal Cell/epidemiology ; Cohort Studies ; Databases, Factual/statistics & numerical data ; Female ; Humans ; Insurance Claim Reporting/statistics & numerical data ; Male ; Middle Aged ; Pyridines/therapeutic use ; Retrospective Studies ; Skin Neoplasms/drug therapy ; Skin Neoplasms/epidemiology ; United States/epidemiology
    Chemical Substances Anilides ; HhAntag691 ; Pyridines
    Language English
    Publishing date 2018-03-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2145090-0
    ISSN 1545-9616
    ISSN 1545-9616
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  10. Article ; Online: Risk of cutaneous squamous cell carcinoma after treatment of basal cell carcinoma with vismodegib.

    Bhutani, Tina / Abrouk, Michael / Sima, Camelia S / Sadetsky, Natalia / Hou, Jeannie / Caro, Ivor / Chren, Mary-Margaret / Arron, Sarah T

    Journal of the American Academy of Dermatology

    2017  Volume 77, Issue 4, Page(s) 713–718

    Abstract: Background: Vismodegib is a first-in-class agent targeting the hedgehog signaling pathway for treatment of patients with locally advanced basal cell carcinoma (BCC) and metastatic BCC. There have been concerns about the development of squamous cell ... ...

    Abstract Background: Vismodegib is a first-in-class agent targeting the hedgehog signaling pathway for treatment of patients with locally advanced basal cell carcinoma (BCC) and metastatic BCC. There have been concerns about the development of squamous cell carcinoma (SCC) in patients treated with this drug.
    Objective: We sought to determine whether treatment with vismodegib is associated with an increase in the risk of cutaneous SCC.
    Methods: In this retrospective cohort study, patients treated with vismodegib as part of phase I and II clinical studies were compared with participants from the University of California, San Francisco, Nonmelanoma Skin Cancer Cohort who received standard therapy for primary BCC. In total, 1675 patients were included in the analysis, and the development of SCC after vismodegib exposure was assessed.
    Results: The use of vismodegib was not associated with an increased risk of subsequent development of SCC (adjusted hazard ratio, 0.57; 95% confidence interval, 0.28-1.16). Covariates including age, sex, history of previous nonmelanoma skin cancer, and number of visits per year were significantly associated with the development of SCC.
    Limitations: A limitation of the study was that a historic control cohort was used as a comparator.
    Conclusions: Vismodegib was not associated with an increased risk of subsequent SCC when compared with standard surgical treatment of BCC.
    MeSH term(s) Age Factors ; Aged ; Aged, 80 and over ; Anilides/therapeutic use ; Antineoplastic Agents/therapeutic use ; Carcinoma, Basal Cell/drug therapy ; Carcinoma, Basal Cell/secondary ; Carcinoma, Basal Cell/surgery ; Carcinoma, Squamous Cell/epidemiology ; Clinical Trials, Phase I as Topic ; Clinical Trials, Phase II as Topic ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Second Primary/epidemiology ; Office Visits/statistics & numerical data ; Pyridines/therapeutic use ; Retrospective Studies ; Risk Factors ; Sex Factors ; Skin Neoplasms/drug therapy ; Skin Neoplasms/epidemiology ; Skin Neoplasms/pathology ; Skin Neoplasms/surgery
    Chemical Substances Anilides ; Antineoplastic Agents ; HhAntag691 ; Pyridines
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603641-7
    ISSN 1097-6787 ; 0190-9622
    ISSN (online) 1097-6787
    ISSN 0190-9622
    DOI 10.1016/j.jaad.2017.03.038
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