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Background: Hedgehog pathway inhibitors, including sonidegib and vismodegib, represent the treatment strategy for 'difficult-to-treat' basal cell carcinoma (BCC), encompassing, among others, locally advanced (laBCC) and metastatic BCC. Assessment of therapy response is challenging due to the presence of telangiectasia and scar tissue at the area of the BCC lesion. Line-field confocal optical coherence tomography (LC-OCT) is a new noninvasive imaging technique that provides high-resolution visualization of skin structures.
Objectives: To investigate the value of LC-OCT for the assessment of laBCC response to sonidegib therapy.
Methods: We retrospectively included patients with laBCC treated with sonidegib in the period from May 2020 to May 2023. Patients with laBCC underwent LC-OCT at baseline before starting sonidegib, and after sonidegib discontinuation when clinical complete response (CR) was reached. A subset of patients underwent LC-OCT assessment during sonidegib therapy to assess tumour persistence.
Results: Twenty laBCCs in 20 patients [4 women, 16 men; mean (SD) age 76 (18) years] treated with oral sonidegib 200 mg daily were included in the study. Ten patients obtained an apparent clinical CR; LC-OCT imaging confirmed CR in 7/10 patients (70%), while in the remaining patients (3/10, 30%) LC-OCT revealed findings indicative of BCC non-CR. Ten patients were continuing sonidegib treatment: in this group LC-OCT revealed findings suggestive of BCC persistence in all 10 patients (100%).
Conclusions: In this study we provide preliminary results of the beneficial use of LC-OCT in the management of patients with laBCC treated with sonidegib therapy.
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http://dx.doi.org/10.1093/skinhd/vzae025 | DOI Listing |
Clin Exp Dermatol
August 2025
Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy.
Background: Hedgehog Pathway Inhibitors (HHIs) should be offered to patients with advanced BCC as a first line treatment. Two systemic HHIs are currently available: sonidegib and vismodegib.
Objective: Since there is no head-to-head trial of sonidegib versus vismodegib and very few comparative studies have been published, we aimed at prospectively describing our long-term approach to manage advanced BCC based on our 10 years' experience with HHIs.
J Pers Med
June 2025
UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy.
Systemic therapy with hedgehog pathway inhibitors (HHIs) and anti-programmed cell death protein 1 (PD-1) antibodies represent the first- and second-line treatment options for advanced basal cell carcinoma (aBCC), respectively. A shift in the treatment paradigms toward the neoadjuvant approach is gaining increasing interest in aBCC management, whereby prior systemic therapy followed by surgery is likely to yield more favorable outcomes. The aim of this narrative review is to summarize the current evidence on systemic treatment options and the neoadjuvant approach for aBCC management.
View Article and Find Full Text PDFCancers (Basel)
May 2025
UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy.
/: Long-term outcome data of locally advanced basal cell carcinoma patients who achieve complete response (CR) on hedgehog pathway inhibitors (HHIs) are lacking, highlighting a gap in the identification of the predictors of tumor recurrence. We aimed to investigate the clinical and histological factors associated with locally advanced BCC recurrence after CR on HHIs. : We performed a retrospective multicenter observational study at 14 Italian tertiary referral centers (1 January 2016-1 March 2024).
View Article and Find Full Text PDFInt J Biol Macromol
June 2025
Department of Genetic Engineering, Faculty of Engineering and Technology, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chennai 603203, Tamil Nadu, India. Electronic address:
Cancer stem-like cells (CSCs), a small subset of cells within the tumor microenvironment, favor tumor relapse and remain a major obstacle in cancer therapy. Hence, hyaluronan-based mesoporous silica nano-formulation with phloroglucinol (MSN-PG-HA) was employed in our study to address the cancer relapse by targeting CD44. Various in vitro cellular assays were conducted to assess the nano-formulation's effect on suppressing CSC characteristics in AGS, HCT-116 and SW-620.
View Article and Find Full Text PDFBackground: Hedgehog inhibitors (HHIs) can be used to treat patients with locally advanced basal cell carcinoma (laBCC) who are not candidates for surgery or radiation or whose tumors have recurred following radiation or surgery. The purpose of this expert consensus panel is to guide HHI usage, thereby informing clinical decision-making and optimizing patient care.
Methods: A comprehensive literature search was completed on May 1, 2024, using the keywords "basal cell carcinoma," "hedgehog inhibitor," "sonidegib," and "vismodegib".