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Возможности лекарственной терапии неоперабельной и метастатической базально-клеточной карциномы кожи
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Ключевые слова: базально-клеточная карцинома, рак кожи, сигнальный путь Хэджхог, висмодегиб.
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Basal cell carcinoma (BCC) is a slow growing, locally invasive malignant tumor of epidermis or hair follicles. According to global estimation, up to 2 million new cases of BCC are diagnosed each year. 5-year efficacy results for this disease are relatively satisfactory in comparison with other oncological diseases (disease control rate is up to 95% in case of surgery). Despite this fact there is a category of patients with locally advanced and metastatic forms of the disease, in which surgery cannot be performed. Vismodegib is the first and the only for today medicine that selectively blocks the Hedgehog signaling pathway, pathologically active in BCC. Vismodegib efficacy was confirmed in the ERIVANCE study – disease control rate was 82,3% in inoperable BCC and 71,5% in metastatic BCC (mBCC). Median overall survival (OS) in mBCC patients was 30,9 months, while in patients with inoperable BCC more than half of patients are alive – median OS has not been achieved, which opens new opportunities in the treatment of this unfavorable category of patients.
Key words: basal cell carcinoma, skin cancer, Hedgehog signaling pathway, vismodegib.
2. Ting PT, Kasper R, Arlette JP. Metastatic basal cell carcinoma: report of two cases and literature review. J Cutan Med Surg 2005; 9: 10–5.
3. Costantino D, Lowe L, Brown DL. Basosquamous carcinoma – an under-recognized, high-risk cutaneous neoplasm: case study and review of the literature. J Plan Reconstr Aesthet Surg 2006; 59: 424–8.
4. Kuijpers DI, Thissen MR, Neumann MH. Basal cell carcinoma: treatment options and prognosis, a scientific approach to a common malignancy. Am J Clin Detmotol 2002; 3: 247–59.
5. Thissen MR, Neumann MH, Schouten LJ. A systematic review of treatment modalities for primary basal cell carcinomas. Arch Dermatol 1999; 135: 1177–83.
6. Braun RP, Klumb F, Girard C et al. Three-dimensional reconstruction of basal cell carcinomas. Dermatol Surg 2004; 31: 562–6.
7. Чиссов В.И., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2011 году (заболеваемость и смертность). М.: ФГБУ МНИОИ им. П.А.Герцена Минздрава России, 2013.
8. Rubin AI, Chen EH, Ratner D. Basal-cell carcinoma. N Engl J Med 2005; 353: 2262–9.
9. Gailani MR, Leffell DJ, Ziegler A et al. Relationship between sunlight exposure and a key genetic alteration in basal cell carcinoma. J Natl Cancer Inst 1996; 88: 349–54.
10. Joshi AD, Forsyth MT, Fryeeld DC et al. Demographic and treatment characteristics for advanced basal cell carcinoma (aBCC) in an oncology outpatient setting. J Clin Oncol 2011; 29 (Suppl. 15): abstr. e19001.
11. Seo SH, Shim WH, Shin DH et al. Pulmonary metastasis of basal cell carcinoma. Ann Dermatol 2011; 23 (2): 213–6.
12. Von Hoff DD, LoRusso PM, Rudin CM et al. Inhibition of the hedgehog pathway in advanced basal-cell carcinoma. N Engl J Med 2009; 361: 1164–72.
13. Sekulic A, Migden M, Basset-Seguin N et al. Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma (aBCC): 18-month update of the pivotal ERIVANCE BCC study. Poster presented at: American Society of Clinical Oncology May 31 – June 4 2013. Chicago IL.
14. Grob J, Kunstfeld R, Dreno B et al. Vismodegib, a Hedgehog pathway inhibitor (HPI), in advanced basal cell carcinoma (aBCC): STEVIE study interim analysis in 300 patients. Poster presented at: American Society of Clinical Oncology May 31 – June 4, 2013. Chicago IL.
ФГБУ НИИ онкологии им. Н.Н.Петрова Минздрава РФ, Санкт-Петербург
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E.V.Levchenko