First reported case of concurrent sonidegib and radiotherapy for recurrent, advanced basal cell carcinoma
Abstract
Basal cell carcinoma (BCC ) is the most common human malignancy. Systemic therapy with a sonic hedgehog (SHH) pathway inhibitor plays an important role in the treatment of advanced BCC . Literature on concurrent use of radiation therapy (RT) with SHH inhibitors has been minimal and has solely been focused on vismodegib. We present a case report of a patient with recurrent basal cell carcinoma involving the high-risk area of the face, who was denied surgery due to comorbidities and difficulty in obtaining complete tumor removal without cosmetic or functional impairment. The patient received combined treatment of fractionated radiation with concurrent sonidegib and had complete clinical response with no significant toxicities. This is the first reported case on the use of concurrent RT with sonidegib for management of recurrent basal cell carcinoma of the head and neck.
Keywords: basal cell carcinomaradiation oncologyconcurrent radiotherapysystemic therapysonic hedgehog
References
- Sumaira Z Aasi. Treatment and prognosis of basal cell carcinoma at low risk of recurrence. https://www.uptodate.com/contents/treatment-and-prognosis-of-basal-cell-carcinoma-at-low-risk-of-recurrence#H4133726805 (June, 2020 ).
- Fecher LA, Sharfman WH. Advanced basal cell carcinoma, the hedgehog pathway, and treatment options — role of smoothened inhibitors. Biologics. 2015; 9: 129–140.
- Jain S, Song R, Xie J. Sonidegib: mechanism of action, pharmacology, and clinical utility for advanced basal cell carcinomas. Onco Targets Ther. 2017; 10: 1645–1653.
- Doan HQ, Silapunt S, Migden MR. Sonidegib, a novel smoothened inhibitor for the treatment of advanced basal cell carcinoma. Onco Targets Ther. 2016; 9: 5671–5678.
- Villani A, Costa C, Fabbrocini G, et al. Sonidegib: Safety and Efficacy in Treatment of Advanced Basal Cell Carcinoma. Dermatol Ther (Heidelb). 2020; 10(3): 401–412.
- Jain S, Song R, Xie J. Sonidegib: mechanism of action, pharmacology, and clinical utility for advanced basal cell carcinomas. Onco Targets Ther. 2017; 10: 1645–1653.
- Konings K, Vandevoorde C, Belmans N, et al. The Combination of Particle Irradiation With the Hedgehog Inhibitor GANT61 Differently Modulates the Radiosensitivity and Migration of Cancer Cells Compared to X-Ray Irradiation. Front Oncol. 2019; 9: 391.
- Gu D, Liu H, Su GH, et al. Combining hedgehog signaling inhibition with focal irradiation on reduction of pancreatic cancer metastasis. Mol Cancer Ther. 2013; 12(6): 1038–1048.
- Hehlgans S, Booms P, Güllülü Ö, et al. Radiation Sensitization of Basal Cell and Head and Neck Squamous Cell Carcinoma by the Hedgehog Pathway Inhibitor Vismodegib. Int J Mol Sci. 2018; 19(9).
- Pollom EL, Bui TT, Chang AL, et al. Concurrent Vismodegib and Radiotherapy for Recurrent, Advanced Basal Cell Carcinoma. JAMA Dermatol. 2015; 151(9): 998–1001.
- Raleigh DR, Algazi A, Arron ST, et al. Induction Hedgehog pathway inhibition followed by combined-modality radiotherapy for basal cell carcinoma. Br J Dermatol. 2015; 173(2): 544–546.
- Schulze B, Meissner M, Ghanaati S, et al. Hedgehog pathway inhibitor in combination with radiation therapy for basal cell carcinomas of the head and neck : First clinical experience with vismodegib for locally advanced disease. Strahlenther Onkol. 2016; 192(1): 25–31.
- Odom D, Mladsi D, Purser M, et al. A Matching-Adjusted Indirect Comparison of Sonidegib and Vismodegib in Advanced Basal Cell Carcinoma. J Skin Cancer. 2017; 2017: 6121760.
- Dummer R, Ascierto PA, Basset-Seguin N, et al. Sonidegib and vismodegib in the treatment of patients with locally advanced basal cell carcinoma: a joint expert opinion. J Eur Acad Dermatol Venereol. 2020; 34(9): 1944–1956.
- Sekulic A, Migden MR, Basset-Seguin N, et al. ERIVANCE BCC Investigators, ERIVANCE BCC Investigators. Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: final update of the pivotal ERIVANCE BCC study. BMC Cancer. 2017; 17(1): 332.
- Kish T, Corry L. Sonidegib (Odomzo) for the Systemic Treatment of Adults With Recurrent, Locally Advanced Basal Cell Skin Cancer. P T. 2016; 41(5): 322–325.