Intervention: Vismodegib
Trial phase: Early Phase 1
ATC code: L01XJ01 | L01XX43
SMILES: CS(=O)(=O)c1ccc(C(=O)Nc2ccc(Cl)c(-c3ccccn3)c2)c(Cl)c1
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 15
Group description: Patients receive vismodegib PO daily for 3-6 months based on the size of basal cell carcinoma and then undergo Mohs surgery.

vismodegib: Given PO

Mohs surgery: Undergo Mohs surgery
Eligibility criteria:
Inclusion Criteria:

Study patients must have at least one BCC, > 5 mm, eligible for Mohs surgical removal; patients with BCCs that have been treated before (recurrent BCCs, BCCs that failed other chemotherapy) are eligible for this trial, if they meet size criteria
No Eastern Cooperative Oncology Group (ECOG) or Karnofsky performance status will be employed
Normal hepatic function: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2 x the upper limit of normal (ULN)
Normal renal function : normal serum creatinine defined as <= 2.5 mg/dL
Clinically acceptable complete blood count (CBC)
Ability to understand and the willingness to sign a written informed consent document
The patient is willing to forego surgical treatment of BCCs by up to 6 months, except when the principal investigator (PI) believes that delay in treatment potentially might compromise the health of the subject
Documented negative serum pregnancy test for women of childbearing potential, with agreement to the use of two acceptable methods of contraception during the study and for 7 months after discontinuation of vismodegib
For men with female partners of childbearing potential, agreement to use a latex, non-latex, or any other male condom and to advise their female partners to use an additional acceptable method of birth control during the study and for 2 months after discontinuation of study drug
Be willing to not donate blood or semen for three months following discontinuation of study medications

Exclusion Criteria:

The patient has a history of invasive cancer within the past five years excluding non-melanoma skin cancer, stage I cervical cancer, ductal carcinoma in situ of the breast, or chronic lymphocytic leukemia (CLL) stage 0

The subject has uncontrolled systemic disease, including known human immunodeficiency virus (HIV) positive patients:

The patient has history of congestive heart failure
The patient has clinically important history of liver disease, including viral or hepatitis, current alcohol abuse, or cirrhosis
The patient has any condition or situation which in the investigator's opinion may put the patient at significant risk, could confound the study results, or could interfere significantly with the subject's participation in the study; this includes history of other skin conditions or disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates use of an investigational drug or that might affect interpretation of the results of the study or render the patient at high risk from treatment complications
The patient has a history of hypersensitivity to any of the ingredients in the study medication formulations
The patient is willing to abstain from application of non-study topical medications to the skin for the duration of the study, including prescription and over the counter preparations; for example, topical preparations containing corticosteroids or vitamin A derivatives are not allowed
Pregnant or nursing patients will be excluded from the study