Locally advanced and metastatic basal cell carcinoma: lines of therapy
6 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Neoadjuvant | Vismodegib for several months to shrink large facial tumours before surgery and reduce the defect. | NCCN Guidelines: Basal Cell Skin Cancer | 71 |
Locally advanced
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Locally advanced, first line | Vismodegib (ERIVANCE) or sonidegib (BOLT); intermittent dosing to limit cramps, hair loss and taste loss; surgery or radiotherapy after response where feasible. | NCCN Guidelines: Basal Cell Skin Cancer | 83 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Metastatic disease | Vismodegib or sonidegib; cemiplimab after progression; platinum chemotherapy has only case-series support. | NCCN Guidelines: Basal Cell Skin Cancer | 85 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | After hedgehog inhibitor failure or intolerance | Cemiplimab (approved 2021); clinical trials of intratumoural agents and immunotherapy combinations. | NCCN Guidelines: Basal Cell Skin Cancer | 85 | |
| All comers | Radiotherapy and local options | Radiotherapy for tumours not resectable but still confined; electron beam and superficial radiotherapy for suitable sites; multidisciplinary review of all advanced cases. | NCCN Guidelines: Basal Cell Skin Cancer | 93 | |
| All comers | Gorlin syndrome | Surveillance and surgery, avoidance of radiotherapy, hedgehog inhibitors for multiple advanced tumours, topical patidegib in trials. | NCCN Guidelines: Basal Cell Skin Cancer | 71 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.