Overcoming Resistance to Hedgehog Inhibitors with Radiotherapy: The First Clinical Case of Concurrent Sonidegib and Radiotherapy for Advanced Basal Cell Carcinoma Progressing on Hedgehog Inhibitors

Grimaldi AM, Barletta E, Tinessa V, Germano D, Ricci V, Bareschino MA, Paciolla I, Argenone A, Perillo A, Muccio CF, Savarese F, Bencivenga A, Cusano F, Sarracco G and Pironti T

Medical Oncology Unit, AORN “San Pio”, Italy
Radiation Oncology Unit, AORN “San Pio”, Italy
Neuroradiology Unit, AORN “San Pio”, Italy
Radiology Unit, AORN “San Pio”, Italy
Dermatology Unit, AORN “San Pio”, Italy

^*Correspondance to: Antonio M Grimaldi 

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Abstract:

Introduction: Basal cell carcinoma is the most common human skin cancer. Systemic therapy with a hedgehog inhibitor should be considered as first-line treatment of unresectable advanced BCC. Some case reports were published on concurrent use of radiation therapy with hedgehog inhibitors and have especially been focused on vismodegib. Case Report: We present a case report of a patient with locally advanced basal cell carcinoma involving a large and high-risk area of the face who, after an initial response to the hedgehog inhibitor sonidegib, progressed during treatment. The patient then received combined treatment of fractionated radiation with concurrent sonidegib and had complete clinical response with no significant toxicities. Conclusion: This is the first reported case on the use of concurrent radiotherapy and sonidegib for management of locally advance basal cell carcinoma of the head and neck progressing during hedgehog inhibitors treatment. It suggests that radiotherapy may be useful to overcome the resistance to the hedgehog inhibitor, retain the patient on the most efficacious first-line hedgehog inhibitor and avoid or postpone the switch to the second-line immunotherapy.

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Cite the Article:

Grimaldi AM, Barletta E, Tinessa V, Germano D, Ricci V, Bareschino MA, et al. Overcoming Resistance to Hedgehog Inhibitors with Radiotherapy: The First Clinical Case of Concurrent Sonidegib and Radiotherapy for Advanced Basal Cell Carcinoma Progressing on Hedgehog Inhibitors. Clin Oncol. 2024;9:2078..