To evaluate the efficacy, safety, and recurrence outcomes of vismodegib in treating periocular and orbital basal cell carcinoma (BCC) through a systematic review and meta-analysis.
Key Findings:
Eighteen studies with a total of 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 after discontinuation was reported in 17.4% (95% CI: 7.0–30.3).
Exenteration was performed in 28.1% (95% CI: 12.3–34.5) despite vismodegib therapy.
Adverse events were reported in 90.3% of patients, with common events including alopecia (57.1%) and muscle spasms (65.8%).
Interpretation:
Vismodegib shows meaningful tumor regression in periocular and orbital BCC, aiding in globe preservation and reducing exenteration needs, but high recurrence rates and significant adverse events limit long-term tolerability.
Limitations:
High incidence of adverse events leading to treatment discontinuation (31.2%), including severe events.
Limited data on long-term outcomes and recurrence rates post-treatment.
Conclusion:
Vismodegib is effective for periocular and orbital BCC but requires careful patient selection and monitoring due to significant adverse effects and recurrence risks.
