Palla M*, Scarpato L and Ascierto P
Istituto Nazionale Tumori Fondazione G. Pascale, ItalyFulltext PDF
Background: The COVID-19 pandemic is having a serious effect on the management of cancer patients. Patients suffering from locally advanced Basal Cell Carcinoma (laBCC) are at a high risk for severe COVID-19, mainly in terms of age and presence of comorbidities. Case Presentation: Here we report the case of an 89-year-old female with a laBCC on the forehead and on concomitant use of antipsychotic medications. After several recurrences and different unsuccessful treatments, the patient refused a further surgery and a multidisciplinary board decided to start treatment with sonidegib, a hedgehog inhibitor approved as first-line treatment in laBCC. We started with sonidegib 200 mg every day and then, due to mild adverse events most probably related to the concomitant antipsychotics, we switched to the in-label dose modification of 200 mg every other day. Due to the COVID-19 outbreak, we decided to follow the patient via telemedicine. Response was impressive and clinically evident after one month of therapy. Currently, after 3 months from the start of sonidegib treatment, the patient presents an almost complete response with residual crust and is still on treatment with sonidegib. Conclusion: Even though laBCC patients are more susceptible to severe complications of COVID-19 than the general population, there is so far no evidence in favor of preventively stopping treatment. Approved dose modifications and telemedicine are interesting strategies not only to control adverse events but also to manage treatment more flexibly during COVID-19 pandemic.
Covid-19; Covid; Corona Virus; Coronavirus disease 2019
Palla M, Scarpato L, Ascierto P. Management with Sonidegib of Advanced BCC in COVID-19 Era. Ann Clin Case Rep. 2020; 5: 1856.