Frontiers in medicine · 2026
Efficacy and safety of vismodegib in periocular and orbital basal cell carcinoma: a systematic review and meta-analysis.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Alessa Dalal
Аннотация
BACKGROUND: Periocular and orbital basal cell carcinoma (BCC) represents a therapeutic challenge due to its proximity to critical structures, the risk of disfigurement, and the potential need for exenteration in advanced disease. Vismodegib, a Hedgehog pathway inhibitor, offers a non-surgical alternative, but its overall efficacy and tolerability in this subset remain unclear.
AIM: This systematic review and meta-analysis aimed to evaluate the efficacy, safety, and recurrence outcomes of vismodegib in periocular and orbital BCC.
METHODS: A systematic search of PubMed, Scopus, and Web of Science was conducted. Eligible studies included prospective or retrospective cohorts and case series with ≥7 patients treated with vismodegib. Primary outcomes were complete and partial response rates; secondary outcomes included recurrence, exenteration, and adverse events. Pooled incidence rates with 95% confidence intervals (CI) were calculated using a random-effects model.
RESULTS: Eighteen studies, with 764 patients, were included. The pooled complete response rate was 38.4% (95% CI: 36.6-57.4), and partial response occurred in 39.2% (95% CI: 32.4-47.5). Recurrence following discontinuation was reported in 17.4% (95% CI: 7.0-30.3). Despite vismodegib therapy, exenteration was performed in 28.1% (95% CI: 12.3-34.5). Adverse events were almost universal (90.3, 95% CI: 81.0-94.8), with alopecia (57.1%), muscle spasms (65.8%), decreased appetite/anorexia (28.2%), and weight loss (38.2%) being the most frequent. Severe adverse events (grade ≥3) occurred in 25.5% of patients, and treatment discontinuation due to toxicity was noted in 31.2%.
CONCLUSION: Vismodegib provides meaningful tumor regression in periocular and orbital BCC, enabling globe preservation in a subset of patients and reducing the need for exenteration. However, high recurrence rates after discontinuation and the substantial burden of adverse events limit long-term tolerability. Careful patient selection and close monitoring are essential for optimizing outcomes.
AIM: This systematic review and meta-analysis aimed to evaluate the efficacy, safety, and recurrence outcomes of vismodegib in periocular and orbital BCC.
METHODS: A systematic search of PubMed, Scopus, and Web of Science was conducted. Eligible studies included prospective or retrospective cohorts and case series with ≥7 patients treated with vismodegib. Primary outcomes were complete and partial response rates; secondary outcomes included recurrence, exenteration, and adverse events. Pooled incidence rates with 95% confidence intervals (CI) were calculated using a random-effects model.
RESULTS: Eighteen studies, with 764 patients, were included. The pooled complete response rate was 38.4% (95% CI: 36.6-57.4), and partial response occurred in 39.2% (95% CI: 32.4-47.5). Recurrence following discontinuation was reported in 17.4% (95% CI: 7.0-30.3). Despite vismodegib therapy, exenteration was performed in 28.1% (95% CI: 12.3-34.5). Adverse events were almost universal (90.3, 95% CI: 81.0-94.8), with alopecia (57.1%), muscle spasms (65.8%), decreased appetite/anorexia (28.2%), and weight loss (38.2%) being the most frequent. Severe adverse events (grade ≥3) occurred in 25.5% of patients, and treatment discontinuation due to toxicity was noted in 31.2%.
CONCLUSION: Vismodegib provides meaningful tumor regression in periocular and orbital BCC, enabling globe preservation in a subset of patients and reducing the need for exenteration. However, high recurrence rates after discontinuation and the substantial burden of adverse events limit long-term tolerability. Careful patient selection and close monitoring are essential for optimizing outcomes.