Metatypical Metastatic Basal Cell Carcinoma Treated with Vismodegib: Report of Two Cases

Results: An objective response was observed from the first month of treatment, with a 25% decrease in the size of the tumors in the nasal root and nasojugal area.After the fifth month, there was a 25% decrease in the eyelid tumor with improvement in ectropion, as well as disappearance of the nasal tumors and a 75% decrease in the nasojugal tumor (partial response).There were no adverse events except for grade 2 eyebrow and eyelash alopecia.After the fifth month, there was a 25% decrease in the eyelid tumor with improvement in ectropion, as well as disappearance of the nasal tumors and a 75% decrease in the nasojugal tumor (partial response).There were no adverse events except for grade 2 eyebrow and eyelash alopecia. Conclusions:In patients who are not candidates for surgery or other treatment approaches, systemic therapy with a HPI is recommended, although evidence in NBCCS is scarce.Both vismodegib and sonidegib have been shown to be effective, with objective response rates in approximately 60% of patients.[2]Long-term treatment is needed, and side effects often require alternative dosing schedules to improve tolerability.No head-to-head studies have been conducted comparing vismodegib and sonidegib.Therefore, sonidegib was chosen due to its higher skin concentrations, better safety profile and the approved alternate-day dose regimen.We present a young patient with GS with rapid clinical and cosmetic benefit and good tolerability after treatment with sonidegib.Further studies are needed to establish dosing schedules that will optimize long-term benefit and tolerability.