A large unilateral basal cell carcinoma treated with Hedgehog inhibitor sonidegib: a case report

Maria Alessandra Mattioli; Valentina Benzecry; Giulia Murgia; Nerina Denaro; Angelo Valerio Marzano; Emanuela Passoni; Gianluca Nazzaro

doi:10.4081/dr.2024.10152

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. BCCs are categorized into “easy-to-treat” and “difficult-to-treat” groups, with the latter including all BCCs that are challenging to manage due to technical, patient-related, or tumor-related factors, such as locally advanced BCCs. In this report, we describe an 84-year-old patient with an extensive, unilateral BCC. Following a decision by the multidisciplinary skin cancer board, the patient was successfully treated with a daily dose of 200 mg of sonidegib, an inhibitor of the Hedgehog pathway, for eight months, acquiring complete clinical and histopathological remission. No significant side effects were reported. The follow-up period of 24 months has shown no negative results.

Peris K, Fargnoli MC, Kaufmann R, et al. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer 2023;192:113254. DOI: https://doi.org/10.1016/j.ejca.2023.113254

Reifenberger J, Wolter M, Knobbe CB, et al. Somatic mutations in the PTCH, SMOH, SUFUH and TP53 genes in sporadic basal cell carcinomas. Br J Dermatol 2005;152:43-51. DOI: https://doi.org/10.1111/j.1365-2133.2005.06353.x

Gambini D, Passoni E, Nazzaro G, et al. Basal Cell Carcinoma and Hedgehog Pathway Inhibitors: Focus on Immune Response. Front Med (Lausanne) 2022;9:893063 DOI: https://doi.org/10.3389/fmed.2022.893063

Dika E, Scarfì F, Ferracin M, et al. Basal Cell Carcinoma: A Comprehensive Review. Int J Mol Sci 2020;21:5572. DOI: https://doi.org/10.3390/ijms21155572

Athar M, Li C, Kim AL, et al. Sonic hedgehog signaling in Basal cell nevus syndrome. Cancer Res 2014;74:4967-75. DOI: https://doi.org/10.1158/0008-5472.CAN-14-1666

Khamaysi Z, Bochner R, Indelman M, et al. Segmental basal cell naevus syndrome caused by an activating mutation in smoothened. Br J Dermatol 2016;175:178-81. DOI: https://doi.org/10.1111/bjd.14425

Saeidian AH, Cohen-Nowak A, O'Donnell M, et al. Linear basal cell nevus with a novel mosaic PTCH1 mutation. Exp Dermatol 2020;29:531-4. DOI: https://doi.org/10.1111/exd.14101

Nazzaro G, Benzecry V, Mattioli MA, et al. E. Sonidegib in Locally Advanced Basal Cell Carcinoma: A Monocentric Retrospective Experience and a Review of Published Real-Life Data. Cancers (Basel) 2023;15:3621. DOI: https://doi.org/10.3390/cancers15143621

Bossi P, Ascierto PA, Basset-Seguin N, et al. Long-term strategies for management of advanced basal cell carcinoma with hedgehog inhibitors. Crit Rev Oncol Hematol 2023;189:104066. DOI: https://doi.org/10.1016/j.critrevonc.2023.104066

Dasgeb B, Pajouhanfar S, Jazayeri A, et al. Novel PTCH1 and concurrent TP53 mutations in four patients with numerous non-syndromic basal cell carcinomas: The paradigm of oncogenic synergy. Exp Dermatol 2022;31:736-42. DOI: https://doi.org/10.1111/exd.14510

Kilgour JM, Jia JL, Sarin KY. Review of the Molecular Genetics of Basal Cell Carcinoma; Inherited Susceptibility, Somatic Mutations, and Targeted Therapeutics. Cancers (Basel) 2021;13:3870. DOI: https://doi.org/10.3390/cancers13153870

Mattioli, M. A., Benzecry, V., Murgia, G., Denaro, N., Marzano, A. V., Passoni, E., & Nazzaro, G. (2024). A large unilateral basal cell carcinoma treated with Hedgehog inhibitor sonidegib: a case report. Dermatology Reports. https://doi.org/10.4081/dr.2024.10152