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Vismodegib for locally advanced basal cell carcinoma in a heart transplant patient
Journal article   Open access   Peer reviewed

Vismodegib for locally advanced basal cell carcinoma in a heart transplant patient

Carrie Ann Cusack, Rohit Nijhawan, Brett Miller, Mira Henien, Gregory Malat, Alden Doyle and Mark Abdelmalek
JAMA dermatology (Chicago, Ill.), v 151(1)
Jan 2015
DOI: https://doi.org/10.1001/jamadermatol.2014.1894
PMID: 25337679
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1001/jamadermatol.2014.1894View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Aged Anilides - adverse effects Anilides - therapeutic use Antineoplastic Agents - adverse effects Antineoplastic Agents - therapeutic use Carcinoma, Basal Cell - drug therapy Carcinoma, Basal Cell - etiology Carcinoma, Basal Cell - pathology Cyclosporine - adverse effects Cyclosporine - pharmacokinetics Cyclosporine - therapeutic use Drug Monitoring - methods Facial Neoplasms - drug therapy Facial Neoplasms - etiology Facial Neoplasms - pathology Heart Transplantation - methods Humans Immunocompromised Host Immunosuppressive Agents - adverse effects Immunosuppressive Agents - pharmacokinetics Immunosuppressive Agents - therapeutic use Male Pyridines - adverse effects Pyridines - therapeutic use Skin Neoplasms - drug therapy Skin Neoplasms - etiology Skin Neoplasms - pathology
Immunosuppressed patients with solid organ transplants have an increased risk for nonmelanoma skin cancer. Vismodegib has been reported to be effective for select locally advanced or metastatic basal cell carcinomas. However, there is no data documenting the use and safety of vismodegib in immunosuppressed organ transplant patients. We describe a 78-year-old white man with a history of orthotopic heart transplant, immunosuppressed with low-dose cyclosporine, who presented to a specialty dermatology transplant clinic with multiple, recurrent, locally aggressive facial basal cell carcinomas. Through a multidisciplinary approach, the patient was started on vismodegib therapy. The pharmacokinetics of cyclosporine in the setting of vismodegib administration and weekly monitoring of cyclosporine levels ensured that therapeutic immunosuppression levels were achieved without toxic effects. To our knowledge, this is the first report that details vismodegib use in an immunosuppressed heart transplant patient receiving cyclosporine therapy. With a growing immunosuppressed organ transplant population at high risk for basal cell carcinoma, therapeutic options for locally advanced or metastatic disease are limited. Vismodegib appears to be a safe option for patients receiving cyclosporine therapy with routine monitoring. Future research is needed to evaluate the safety profile of vismodegib with other immunosuppressive agents.

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11 citations in Web of Science
90 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Web of Science research areas
Dermatology
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