Guidelines for vismodegib in the management of periocular basal cell carcinoma
| Autor: | Vladimir Kratky, Navdeep Nijhawan, Isabelle Hardy, Dan DeAngelis, Vivian T. Yin, Aftab Zafar, James H. Oestreicher, Ahsen Hussain, Babak Maleki, Harmeet S. Gill, Nancy A. Tucker, Edsel Ing, J. J. Hurwitz, Bryan Arthurs |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Canada medicine.medical_specialty Skin Neoplasms Pyridines education Locally advanced Vismodegib Antineoplastic Agents Multidisciplinary team 03 medical and health sciences 0302 clinical medicine medicine Humans Periocular Region Anilides Basal cell carcinoma Adult patients business.industry Expert consensus General Medicine Guideline medicine.disease Ophthalmology Treatment Outcome Carcinoma Basal Cell Family medicine 030221 ophthalmology & optometry business medicine.drug |
| Zdroj: | Canadian Journal of Ophthalmology. 55:245-252 |
| ISSN: | 0008-4182 |
| DOI: | 10.1016/j.jcjo.2019.11.004 |
| Popis: | Objective The management of advanced basal cell carcinoma (BCC) in the periocular region remains a clinical challenge. Vismodegib (ErivedgeTM) has been approved in 2013 by Health Canada for adult patients with “histologically confirmed metastatic BCC or locally advanced BCC inappropriate for surgery or radiation.” An expert consensus was sought to create a standardised approach in the use of this novel treatment. Methods Fourteen practicing oculoplastic surgeons across Canada were involved in formulating and reviewing guidelines until consensus was reached. A consultancy meeting was followed by further ratification of guidelines over email. Two voting surveys were performed of the group to objectively assess agreement over each statement within the guidelines. Ratification continued until at least two-thirds of the group agreed on every guideline statement. Results The guidelines summarize 21 statements in a major and minor criteria format. A multidisciplinary team review is suggested for each patient with the involvement of recommended specialists. The internal survey revealed 100% agreement over 9 statements, 91.7% agreement over 8 statements, 83.3% agreement over 4 statements, and 2 statements had 66.7% and 58.7% agreement each. All statements with less than 91.7% agreement were surveyed again, and they were kept, modified, or removed on the basis of a consensus of over 66.7%. Conclusions These guidelines serve to act as a framework for physicians considering vismodegib for the medical management of patients with advanced or metastatic periocular BCC. Future applications, including neoadjuvant uses of the drug, may become apparent through further research. |
| Databáze: | OpenAIRE |
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