Basal Cell Carcinoma. Advances in Treatment and Research

Preface
Contents
Contributors
Editor Biographies
Chapter 1: Epidemiology and Risk Factors of Basal Cell Carcinoma
	Epidemiology
		Introduction
		Geography
		Demographics
		Location and Histologic Subtype
		Morbidity and Mortality
		Economic Burden
		Prevention
	Risk Factors
		Introduction
		UV Radiation
		Photosensitizing Medications
		Ionizing Radiation
		Chemical Exposures
		Immunosuppression
		Genes
	Conclusion
	References
Chapter 2: Pathophysiology of Basal Cell Carcinoma and Its Associated Genetic Syndromes
	Introduction
	Basal Cell Nevus Syndrome (BCNS)
	Bazex-Dupre-Christol Syndrome
	Rombo Syndrome
	Additional Genetic Syndromes with Increased Risk of Basal Cell Carcinoma
	References
Chapter 3: Histopathology of Basal Cell Carcinoma and Its Variants
	Introduction
	Common Histologic Features
	Histologic Variants
		Nodular Basal Cell Carcinoma
		Superficial Basal Cell Carcinoma
		Infundibulocystic/Hamartomatous Basal Cell Carcinoma
		Fibroepithelioma of Pinkus
		Infiltrative Basal Cell Carcinoma
		Morpheaform Basal Cell Carcinoma
		Micronodular Basal Cell Carcinoma
		Clear Cell Basal Cell Carcinoma
		Adenoid Basal Cell Carcinoma
		Pleomorphic Basal Cell Carcinoma
		Keratotic Basal Cell Carcinoma
		Basal Cell Carcinoma with Matrical Differentiation
		Basal Cell Carcinoma with Ductal Differentiation
		Metaplastic Basal Cell Carcinoma
	High-Risk Features
	References
Chapter 4: Topical Therapy for the Treatment of Basal Cell Carcinoma
	Introduction
	Background
	Mechanism of Action
		Imiquimod
		5-Fluorouracil
		Ingenol Mebutate
	Efficacy
		Imiquimod
		5-Fluorouracil
		Ingenol Mebutate
	Safety
		Imiquimod
		5-Fluorouracil
		Ingenol Mebutate
	Comparative Studies
		Imiquimod
			Comparison of Different Treatment Regimens of Imiquimod to Vehicle Cream
			Comparison of Imiquimod to Other Treatment Modalities
		5-Fluorouracil
		Ingenol Mebutate
	Emerging Topical Treatments and Combination Therapies
	Combination Therapies
		Imiquimod Plus CT
		Imiquimod Plus PDT
		Imiquimod Plus Curettage
		Imiquimod Plus MMS
		5-FU Combination Therapy
	Discussion and Conclusions
	References
Chapter 5: Local Immunotherapy for Basal Cell Carcinoma with Interferon
	Introduction
	Background
		Role of the Immune System
		Treatment with Immunostimulatory Agents (ISRX)
			Efficacy
			Low Recurrence Rate
			Normal Skin Markings
			Cosmesis
			Preservation of Function
			No Wound
			All Other Therapeutic Options Remain Open
		Disadvantages of ISRX
	Mechanism of Action of ISRX
		Patient/Tumor Selection
		Interferon Injections
			Preparation of IFN for Injection
			Injection Technique
			Dosage of IFN
			Combination of IFN with IMIQ
			Side Effects
			Recommended Follow-Up for BCC Treated with ISRX
	Conclusion
	References
Chapter 6: Cryotherapy and Electrodesiccation & Curettage for Basal Cell Carcinoma
	Introduction
	Cryotherapy
		Background
		Mechanism of Action
		Efficacy
		Safety
		Comparative Studies
		Discussion
	Electrodesiccation and Curettage
		Background
		Mechanism of Action
		Efficacy
		Operator Dependence and Technique
		Tumor Characteristics
		Safety
		Comparative Studies
		Discussion
	Conclusions
	References
Chapter 7: Mohs Micrographic Surgery for the Treatment of Basal Cell Carcinoma
	Historical Perspective of Mohs Micrographic Surgery
	Preoperative Evaluation
	Site Identification
	Anticoagulant and Antiplatelet Use
	Indication for Prophylactic Antibiotic Use
	Pacemaker and AICD
	Imaging
	Consultation
	Smoking
	The Mohs Micrographic Surgery Procedure
	Debulking
	Incision
	Retraction
	Excision
	Coagulation
	Tissue Processing
	Tissue Embedding, Cutting, Staining, and Coverslipping
	Histologic Interpretation
	Repair of Surgical Defect
	Conclusion
	References
Chapter 8: Surgical Treatment for Basal Cell Carcinoma of the Head and Neck
	Introduction and Epidemiology
	Risk Factors and Pathogenesis
		Environmental Risk Factors
		Molecular Pathogenesis
	Presentation and Work-Up
	Treatment
	Conclusion
	References
Chapter 9: Special Considerations for Periocular Basal Cell Carcinoma
	Introduction
	Epidemiology
	Surgical Excision
		Wide Local Excision and Handling of Eyelid Specimens
	Mohs Micrographic Surgery
	Topical Imiquimod
	Reconstructive Considerations in the Periocular Region
		Upper Eyelid Defects
		Lower Eyelid Defects
		Medial Canthal Defects
		Lateral Canthal Defects
	Locally Advanced Disease in the Periocular Region
		Anatomic and Functional Considerations
		Orbital Exenteration
		Radiation Therapy and Ocular Toxicity
		Sonic Hedgehog Inhibitors for Locally Advanced BCC in the Periocular Region
	Conclusions
	References
Chapter 10: Radiotherapy for Basal Cell Carcinoma
	Introduction
	Radiotherapy Options
		Definitive Radiotherapy
		Adjuvant Radiotherapy
		Radiotherapy to Regional Nodal Stations
	Radiotherapy Modalities/Techniques
		Orthovoltage Irradiation
		Electron Beam Therapy
		Megavoltage Photons (Intensity-Modulated Radiotherapy (IMRT)/Volumetric Modulated Arc Therapy (VMAT))
		Proton Therapy
		Brachytherapy
	Side Effects
		Acute Side Effects
		Late Side Effects
	Expected Outcomes After Radiotherapy
	Case Studies
		Electron Beam Therapy
		Megavoltage Photon Therapy (VMAT)
	Conclusion
	References
Chapter 11: Photodynamic Therapy for the Treatment of Basal Cell Carcinoma
	Introduction
	Background
	Mechanism of Action
	Efficacy
	Safety
	Comparative Studies
		PDT Versus Placebo
		PDT Versus Other Treatment Modalities
		Comparison of Different PDT Treatment Regimens
	Discussion
	Conclusions
	References
Chapter 12: Laser Therapy for the Treatment of Basal Cell Carcinoma
	Introduction
	Background
	Mechanism of Action
	Efficacy
	CO2 Laser
	Pulsed Dye Laser
	Other Lasers
	Laser Therapy with Intraoperative Cellular Evaluation
	Combination Therapy
	Safety
	Comparative Studies
		CO2 Laser
		Pulse Dye Laser
		Other Lasers and Combination Therapy
	Discussion
	Conclusions
	References
Chapter 13: Hedgehog Signaling Pathway Inhibitors for Basal Cell Carcinoma
	Introduction
	Background
	Vismodegib
		Drug Development
		Clinical Trials
		Safety and Tolerability
		Administration and Precautions
	Sonidegib
		Drug Development
		Clinical Trials
	Safety and Tolerability
	Administration and Precautions
	Post-trial Concerns and Present Challenges
	Management of HPI-Associated Adverse Events
	Neoadjuvant Use of HPIs
	Other HPIs
	Conclusion
	References
Chapter 14: Immunotherapy for Basal Cell Carcinoma
	Introduction
	PD-1 Inhibitor
		Background and Mechanism of Action
		Nivolumab
		Pembrolizumab
	Cytotoxic T-Lymphocyte-Associated Antigen 4 Inhibitor
		Background and Mechanism of Action
		Ipilimumab
	Discussion
	Conclusion
	References
Chapter 15: Treatment: Future Directions
	Current Treatments and Future Directions
	Physical Modalities
		Photodynamic Therapy (PDT)
		Daylight PDT
	Topical Therapies
		Ingenol Mebutate
		Intralesional Talimogene Laherparepvec
		Topical Hh Inhibitors and Imiquimod
	Systemic Treatment
		Non-Hh Pathway-Specific Therapies
			Immune-Checkpoint Inhibitors
		Hh Pathway-Specific Therapies
			Hh Pathway Inhibitors Currently in Phase I/II Clinical Trials
				LEQ 506
				BMS-833923 (XL139)
				LY2940680
				Patidegib (TAK-441)
			Hh Pathway Inhibitors in Preclinical Phase
				GLI Antagonists (GANTs)
		Other Agents
			Itraconazole
	Preclinical Experimental Models for BCC
	Other Approaches for New Putative Therapy
		T-Cell Therapy
	Conclusion and Outlook
	References
Book Description
Index