Basal cell carcinoma (BCC) is a relatively common form of cancer with a favorable prognosis when treated early. Although most BCCs are easily treated by surgical methods, these lesions occasionally progress to an advanced state that is no longer conducive to surgery or radiation therapy. Even more rarely, the lesions spread to distant sites. Until recently, treatment for locally advanced and metastatic BCC were restricted to chemotherapy and radiation; however, the effectiveness of traditional chemotherapeutic methods in treating locally advanced or metastatic BCC is limited at best. Recent discoveries in the fields of molecular biology have found important pathways implicated in the pathogenesis of BCC. Among these are the epidermal growth factor receptor and hedgehog pathways, which are now being targeted by new biologic therapies. Despite a paucity of phase II and III trial data, preliminary evidence demonstrating the disease-stabilizing ability of biologic therapies in locally advanced and metastatic BCC appears promising.
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