Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors

Leslie A Fecher,1,3 William H Sharfman2 1Department of Internal Medicine and Dermatology, Indiana University Health Simon Cancer Center, Indianapolis, IN, USA; 2The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA, 3Department of Internal Medicine and Dermatology, Unive...

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Autores principales: Fecher LA, Sharfman WH
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Publicado: Dove Medical Press 2015
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spelling oai:doaj.org-article:0a9e723d77f845c3a87150274d0be2a32021-12-02T06:12:50ZAdvanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors1177-5491https://doaj.org/article/0a9e723d77f845c3a87150274d0be2a32015-11-01T00:00:00Zhttps://www.dovepress.com/advanced-basal-cell-carcinoma-the-hedgehog-pathway-and-treatment-optio-peer-reviewed-article-BTThttps://doaj.org/toc/1177-5491Leslie A Fecher,1,3 William H Sharfman2 1Department of Internal Medicine and Dermatology, Indiana University Health Simon Cancer Center, Indianapolis, IN, USA; 2The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA, 3Department of Internal Medicine and Dermatology, University of Michigan, MI, USA Abstract: Cutaneous basal cell carcinoma (BCC) is the most common human cancer and its incidence is rising worldwide. Ultraviolet radiation exposure, including tanning bed use, as well as host factors play a role in its development. The majority of cases are treated and cured with local therapies including surgery. Yet, the health care costs of diagnosis and treatment of BCCs in the US is substantial. In the United States, the cost of nonmelanoma skin cancer care in the Medicare population is estimated to be US$426 million per year. While rare, locally advanced BCCs that can no longer be controlled with surgery and/or radiation, and metastatic BCCs do occur and can be associated with significant morbidity and mortality. Vismodegib (GDC-0449), a smoothened inhibitor targeted at the hedgehog pathway, is the first US Food and Drug Association (FDA)-approved agent in the treatment of locally advanced, unresectable, and metastatic BCCs. This class of agents appears to be changing the survival rates in advanced BCC patients, but appropriate patient selection and monitoring are important. Multidisciplinary assessments are essential for the optimal care and management of these patients. For some patients with locally advanced BCC, treatment with a hedgehog inhibitor may eliminate the need for an excessively disfiguring or morbid surgery. Keywords: basal cell carcinoma, hedgehog, smoothened, vismodegib, Gorlin, basal cell nevus syndromeFecher LASharfman WHDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2015, Iss default, Pp 129-140 (2015)
institution DOAJ
collection DOAJ
language EN
topic Medicine (General)
R5-920
spellingShingle Medicine (General)
R5-920
Fecher LA
Sharfman WH
Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors
description Leslie A Fecher,1,3 William H Sharfman2 1Department of Internal Medicine and Dermatology, Indiana University Health Simon Cancer Center, Indianapolis, IN, USA; 2The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA, 3Department of Internal Medicine and Dermatology, University of Michigan, MI, USA Abstract: Cutaneous basal cell carcinoma (BCC) is the most common human cancer and its incidence is rising worldwide. Ultraviolet radiation exposure, including tanning bed use, as well as host factors play a role in its development. The majority of cases are treated and cured with local therapies including surgery. Yet, the health care costs of diagnosis and treatment of BCCs in the US is substantial. In the United States, the cost of nonmelanoma skin cancer care in the Medicare population is estimated to be US$426 million per year. While rare, locally advanced BCCs that can no longer be controlled with surgery and/or radiation, and metastatic BCCs do occur and can be associated with significant morbidity and mortality. Vismodegib (GDC-0449), a smoothened inhibitor targeted at the hedgehog pathway, is the first US Food and Drug Association (FDA)-approved agent in the treatment of locally advanced, unresectable, and metastatic BCCs. This class of agents appears to be changing the survival rates in advanced BCC patients, but appropriate patient selection and monitoring are important. Multidisciplinary assessments are essential for the optimal care and management of these patients. For some patients with locally advanced BCC, treatment with a hedgehog inhibitor may eliminate the need for an excessively disfiguring or morbid surgery. Keywords: basal cell carcinoma, hedgehog, smoothened, vismodegib, Gorlin, basal cell nevus syndrome
format article
author Fecher LA
Sharfman WH
author_facet Fecher LA
Sharfman WH
author_sort Fecher LA
title Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors
title_short Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors
title_full Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors
title_fullStr Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors
title_full_unstemmed Advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors
title_sort advanced basal cell carcinoma, the hedgehog pathway, and treatment options – role of smoothened inhibitors
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/0a9e723d77f845c3a87150274d0be2a3
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