Treatment of periocular advanced basal cell carcinoma with Hedgehog pathway inhibitors: A single-center study and a new dedicated therapeutic protocol


Published: 5 August 2021
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Authors

  • Vincenzo De Giorgi Section of Dermatology, Department of Health Sciences, University of Florence, Italy.
  • Luciana Trane Section of Dermatology, Department of Health Sciences, University of Florence, Italy.
  • Giulia Pieretti Unit of Ocular Oncology - Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy.
  • Nicola Santoro Unit of Ocular Oncology - Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy.
  • Flavia Silvestri Section of Dermatology, Department of Health Sciences, University of Florence, Italy.
  • Federico Venturi Section of Dermatology, Department of Health Sciences, University of Florence, Italy.
  • Federica Scarfi Section of Dermatology, Department of Health Sciences, University of Florence, Italy. https://orcid.org/0000-0001-8911-9152
  • Vincenza Maio Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Italy.
  • Giuseppe Spinelli Maxillofacial Surgery Department, Careggi University Hospital, Florence, Italy.
  • Silvia Scoccianti Radiation Oncology Unit, Azienda Toscana Centro, Florence, Italy.
  • Laura Guerrini Department of Radiology, Santa Maria Nuova Hospital, Florence USL Tuscany Centrum, Florence, Italy.
  • Daniela Massi Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Italy.
  • Cinzia Mazzini Unit of Ocular Oncology - Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy.
  • Laura Doni Medical Oncology, AOUC Hospital, Florence, Italy.

The management of difficult-to-treat periocular basal cell carcinoma (BCC) becomes very challenging in cases of delayed diagnosis, leading to the development of locally advanced BCC. The aim of this study was to evaluate the outcomes of Hedgehog pathway inhibitors (vismodegib and sonidegib) treatment in patients affected by periocular locally advanced BCC. We focused on the common adverse events and their correlation with the administration schedule, to determine a management protocol specific for the periocular area. This observational prospective study included a single-center case series with patients who were histologically confirmed to have periocular or orbital locally advanced BCC, treated with Hedgehog pathway inhibitors. All patients benefitted in terms of regression or stabilization of the neoplasm. In the first months of treatment, the HPIs were well tolerated, and the first important side effects appeared after about 5 months of continuous use of the drug. These data could lead to a new type of therapeutic scheme where neoadjuvant therapy could be followed by pulse therapy as an adjuvant to surgery.


De Giorgi, V., Trane, L., Pieretti, G., Santoro, N., Silvestri , F., Venturi, F., Scarfi, F., Maio, V., Spinelli, G., Scoccianti, S., Guerrini, L., Massi, D., Mazzini, C., & Doni, L. (2021). Treatment of periocular advanced basal cell carcinoma with Hedgehog pathway inhibitors: A single-center study and a new dedicated therapeutic protocol. Dermatology Reports, 13(3). https://doi.org/10.4081/dr.2021.9240

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