Sergi Maria Chiara, Ambrogio Francesca, Della Mura Mario, Sorino Joana, Cazzato Gerardo
Unità Operativa Complessa di Oncologia Medica, Ospedale "Mons. A.R. Dimiccoli" Asl BT, Viale Ippocrate, 15, 70051 Barletta, Italy.
Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", 70124 Bari, Italy.
Cancers (Basel). 2025 Mar 15;17(6):993. doi: 10.3390/cancers17060993.
BCC is the most prevalent form of skin cancer, characterized by diverse clinical and pathological subtypes ranging from indolent to highly aggressive forms. While the majority of BCC cases are treated effectively with surgery or local therapies, locally advanced BCC (laBCC) and metastatic BCC (mBCC) pose significant therapeutic challenges. Recent advances in HHIs and immunotherapy have transformed the treatment landscape in such cases. However, resistance and intolerance to these treatments necessitate alternative approaches, including chemotherapy. Platinum-based agents such as cisplatin and carboplatin have shown limited efficacy but remain viable options in rapidly progressive cases. Among the therapeutic innovations to be explored, further lines of immunotherapy as well as combination therapies involving immunotherapy and targeted therapy have been proposed. This review synthesizes the current understanding about BCC subtypes, risk stratification, and emerging treatments, with a particular focus on laBCC and mBCC.
基底细胞癌（BCC）是最常见的皮肤癌形式，其特征是具有从惰性到高度侵袭性的多种临床和病理亚型。虽然大多数基底细胞癌病例通过手术或局部治疗可得到有效治疗，但局部晚期基底细胞癌（laBCC）和转移性基底细胞癌（mBCC）带来了重大的治疗挑战。刺猬索尼克通路抑制剂（HHIs）和免疫疗法的最新进展改变了此类病例的治疗格局。然而，对这些治疗的耐药性和不耐受性需要采用替代方法，包括化疗。顺铂和卡铂等铂类药物疗效有限，但在快速进展的病例中仍是可行的选择。在有待探索的治疗创新中，有人提出了进一步的免疫治疗方案以及涉及免疫治疗和靶向治疗的联合疗法。本综述综合了目前对基底细胞癌亚型、风险分层和新兴治疗方法的认识，特别关注局部晚期基底细胞癌和转移性基底细胞癌。
