Management of Locally Advanced Basal Cell Carcinoma with Sonic Hedgehog Pathway Targeted Therapy: A Case Report and Discussion

• DOI: 10.1159/000537817
• Publication Date: 2024-03-13T22:00:33Z
• Authors: Neal Ferrin; Darwin Edmond; Ryan Jones; Laurence E. McCahill
• Keywords: Vismodegib; Targeted Therapy

<b><i>Introduction:</i></b> Basal cell carcinoma (BCC) is the most common skin malignancy in world. While lesions are treated using surgical methods, others may present as locally advanced or metastatic disease and not amenable to therapy alone. Treatment with sonic hedgehog pathway inhibitors (vismodegib, sonidegib) designed inhibit key signaling proteins gene pathways involved BCC reduce uncontrolled proliferation of basal cells complicated can be invaluable treating patients disease. <b><i>Case Presentation:</i></b> We describe course a 68-year-old man who presented 7.2 × 6 cm exophytic ulcerated invasive his upper back. The patient was started on daily vismodegib treatment goal eventual resection. After 11 weeks therapy, he had significant improvement both wound size appearance. 18 achieved near complete clinical response central aspect lesion three remaining small peripheral lesions. These were biopsied, two found negative for malignancy, while inferior nodule positive squamous (SCC). Vismodegib discontinued after total 26 therapy. Excision SCC performed, remains free at 2 years. <b><i>Conclusion:</i></b> This case report shows efficacy inhibitor pathologic response, requiring intervention.