{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:45:30Z","timestamp":1778651130979,"version":"3.51.4"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sonic hedgehog inhibitors (SHHis) are an effective treatment in locally advanced basal cell carcinoma (laBCC). However, the use of these drugs is limited by adverse events, and relapse at discontinuation in around one-half of patients. A few cases of patients treated concomitantly by radiotherapy (RT) and SHHis have been reported in the literature, suggesting that the combination results in an improved overall response. Maintaining complete response after stopping treatment is a concern, especially as resuming treatment in the case of relapse does not guarantee a new therapeutic response. The optimal combination and sequence of treatment to improve local control of laBCCs are not yet defined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We hypothesized that consolidation RT after complete response to SHHis could reduce the risk of relapse at discontinuation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We present a case series of patients with laBCCs who achieved complete response after SHHi treatment and were treated with consolidation RT. Patients were evaluated by a skin cancer board. The closure RT technique and dosage were refined by a radiotherapist.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eleven patients were included. SHHis were prescribed for a median 5 months (range 4\u201311). Consolidation RT was performed after complete response to SHHis and discontinuation. RT was delivered at a median dose of 45 Gy (range 40.5\u201366) in 10 fractions (range 9\u201333). With a median follow-up of 23 months, all patients maintained complete clinical response. This strategy was well tolerated with no grade 3 adverse events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SHHi treatment followed by consolidation RT after drug discontinuation seems effective and safe. Further studies are needed to develop a precise strategy for the management of laBCCs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ced\/llae068","type":"journal-article","created":{"date-parts":[[2024,3,3]],"date-time":"2024-03-03T14:05:12Z","timestamp":1709474712000},"page":"1024-1028","source":"Crossref","is-referenced-by-count":7,"title":["Sequential combination of sonic hedgehog inhibitors followed by consolidation radiotherapy in locally advanced basal cell carcinoma"],"prefix":"10.1093","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0924-7371","authenticated-orcid":false,"given":"Marie","family":"Boileau","sequence":"first","affiliation":[{"name":"Department of Dermatology, CHU Lille , Lille , France"},{"name":"Department of Medicine, University of Lille , Lille , France"},{"name":"University of Lille, Inserm, CHU Lille, U1189 \u2013 ONCO-THAI \u2013 Assisted Laser Therapy and Immunotherapy for Oncology , F-Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8465-4225","authenticated-orcid":false,"given":"Manon","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Lille , Lille , France"},{"name":"Department of Medicine, University of Lille , Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1894-0749","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Pruvot","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Lille , Lille , France"},{"name":"Department of Medicine, University of Lille , Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eve","family":"Desmedt","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Lille , Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Templier","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Lille , Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Meyer","sequence":"additional","affiliation":[{"name":"Medical Office, Medipole Garonne , Toulouse , France"},{"name":"CARADERM Network, University Hospital Lille , Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6546-7627","authenticated-orcid":false,"given":"Xavier","family":"Mirabel","sequence":"additional","affiliation":[{"name":"CARADERM Network, University Hospital Lille , Lille , France"},{"name":"University Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center , Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2644-1790","authenticated-orcid":false,"given":"Laurent","family":"Mortier","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Lille , Lille , France"},{"name":"Department of Medicine, University of Lille , Lille , France"},{"name":"CARADERM Network, University Hospital Lille , Lille , France"},{"name":"University of Lille, Inserm, CHU Lille, U1189 \u2013 ONCO-THAI \u2013 Assisted Laser Therapy and Immunotherapy for Oncology , F-Lille , France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"2024082301135007700_llae068-B1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.jaad.2016.06.020","article-title":"Incidence and prevalence of basal cell carcinoma (BCC) and locally advanced BCC (LABCC) in a large commercially insured population in the United States: a retrospective cohort study","volume":"75","author":"Goldenberg","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"2024082301135007700_llae068-B2","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1056\/NEJMoa1113713","article-title":"Efficacy and safety of vismodegib in advanced basal-cell carcinoma","volume":"366","author":"Sekulic","year":"2012","journal-title":"N Engl J Med"},{"key":"2024082301135007700_llae068-B3","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1186\/s12885-017-3286-5","article-title":"Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: final update of the pivotal ERIVANCE BCC study","volume":"17","author":"Sekulic","year":"2017","journal-title":"BMC Cancer"},{"key":"2024082301135007700_llae068-B4","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1111\/bjd.18552","article-title":"Long-term efficacy and safety of sonidegib in patients with advanced basal cell carcinoma: 42-month analysis of the phase II randomized, double-blind BOLT study","volume":"182","author":"Dummer","year":"2020","journal-title":"Br J Dermatol"},{"key":"2024082301135007700_llae068-B5","doi-asserted-by":"crossref","first-page":"1944","DOI":"10.1111\/jdv.16230","article-title":"Sonidegib and vismodegib in the treatment of patients with locally advanced basal cell carcinoma: a joint expert opinion","volume":"34","author":"Dummer","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2024082301135007700_llae068-B6","doi-asserted-by":"crossref","first-page":"3275","DOI":"10.1200\/JCO.18.00794","article-title":"Follow-up of patients with complete remission of locally advanced basal cell carcinoma after vismodegib discontinuation: a multicenter French study of 116 patients","volume":"37","author":"Herms","year":"2019","journal-title":"J Clin Oncol"},{"key":"2024082301135007700_llae068-B7","doi-asserted-by":"crossref","first-page":"100284","DOI":"10.1016\/j.esmoop.2021.100284","article-title":"Efficacy of sonic hedgehog inhibitors rechallenge, after initial complete response in recurrent advanced basal cell carcinoma: a retrospective study from the CARADERM database","volume":"6","author":"Bassompierre","year":"2021","journal-title":"ESMO Open"},{"key":"2024082301135007700_llae068-B8","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ejca.2019.06.003","article-title":"Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines","volume":"118","author":"Peris","year":"2019","journal-title":"Eur J Cancer"},{"key":"2024082301135007700_llae068-B9","doi-asserted-by":"crossref","first-page":"456","DOI":"10.7326\/M18-0678","article-title":"Treatments of primary basal cell carcinoma of the skin: a systematic review and network meta-analysis","volume":"169","author":"Drucker","year":"2018","journal-title":"Ann Intern Med"},{"key":"2024082301135007700_llae068-B10","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1111\/bjd.13748","article-title":"Induction hedgehog pathway inhibition followed by combined-modality radiotherapy for basal cell carcinoma","volume":"173","author":"Raleigh","year":"2015","journal-title":"Br J Dermatol"},{"key":"2024082301135007700_llae068-B11","first-page":"e2354146","article-title":"Upfront radiotherapy with concurrent and adjuvant vismodegib is effective and well-tolerated in a patient with advanced, multifocal basal cell carcinoma","volume":"2018","author":"Franco","year":"2018","journal-title":"Case Rep Dermatol Med"},{"key":"2024082301135007700_llae068-B12","doi-asserted-by":"crossref","first-page":"46","DOI":"10.3892\/mco.2021.2208","article-title":"Pathologic complete response with radiation and vismodegib in a patient with advanced basal cell carcinoma: a case report","volume":"14","author":"Amini","year":"2021","journal-title":"Mol Clin Oncol"},{"key":"2024082301135007700_llae068-B13","doi-asserted-by":"crossref","first-page":"e2247","DOI":"10.1002\/onco.13959","article-title":"Hedgehog inhibitor induction with addition of concurrent superficial radiotherapy in patients with locally advanced basal cell carcinoma: a case series","volume":"26","author":"Weissman","year":"2021","journal-title":"Oncologist"},{"key":"2024082301135007700_llae068-B14","doi-asserted-by":"crossref","first-page":"149","DOI":"10.5603\/RPOR.a2021.0010","article-title":"First reported case of concurrent sonidegib and radiotherapy for recurrent, advanced basal cell carcinoma","volume":"26","author":"Wang","year":"2021","journal-title":"Rep Pract Oncol Radiother"},{"key":"2024082301135007700_llae068-B15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s00066-015-0902-7","article-title":"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","volume":"192","author":"Schulze","year":"2016","journal-title":"Strahlenther Onkol"},{"key":"2024082301135007700_llae068-B16","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1001\/jamadermatol.2015.0326","article-title":"Concurrent vismodegib and radiotherapy for recurrent, advanced basal cell carcinoma","volume":"151","author":"Pollom","year":"2015","journal-title":"JAMA Dermatol"},{"key":"2024082301135007700_llae068-B17","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1001\/jamadermatol.2015.0977","article-title":"Potential synergy of radiation therapy with vismodegib for basal cell carcinoma","volume":"151","author":"Strasswimmer","year":"2015","journal-title":"JAMA Dermatol"},{"key":"2024082301135007700_llae068-B18","doi-asserted-by":"crossref","first-page":"344","DOI":"10.5603\/RPOR.a2022.0038","article-title":"FLASH radiotherapy: an emerging approach in radiation therapy","volume":"27","author":"Matuszak","year":"2022","journal-title":"Rep Pract Oncol Radiother"},{"key":"2024082301135007700_llae068-B19","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1667\/RADE-20-00090","article-title":"flash irradiation results in reduced severe skin toxicity compared to conventional-dose-rate irradiation","volume":"194","author":"Soto","year":"2020","journal-title":"Radiat Res"},{"key":"2024082301135007700_llae068-B20","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1001\/jamainternmed.2013.639","article-title":"Treatment of nonfatal conditions at the end of life: nonmelanoma skin cancer","volume":"173","author":"Linos","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2024082301135007700_llae068-B21","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1093\/annonc\/mdy228","article-title":"Addressing the quality of life needs of older patients with cancer: a SIOG consensus paper and practical guide","volume":"29","author":"Scott\u00e9","year":"2018","journal-title":"Ann Oncol"},{"key":"2024082301135007700_llae068-B22","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1038\/s41586-018-0596-y","article-title":"A cell identity switch allows residual BCC to survive Hedgehog pathway inhibition","volume":"562","author":"Biehs","year":"2018","journal-title":"Nature"},{"key":"2024082301135007700_llae068-B23","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1038\/s41586-018-0603-3","article-title":"A slow-cycling LGR5 tumour population mediates basal cell carcinoma relapse after therapy","volume":"562","author":"S\u00e1nchez-Dan\u00e9s","year":"2018","journal-title":"Nature"},{"key":"2024082301135007700_llae068-B24","doi-asserted-by":"crossref","first-page":"6565","DOI":"10.1158\/1078-0432.CCR-06-0176","article-title":"Hedgehog: an attribute to tumor regrowth after chemoradiotherapy and a target to improve radiation response","volume":"12","author":"Sims-Mourtada","year":"2006","journal-title":"Clin Cancer Res"},{"key":"2024082301135007700_llae068-B25","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.ijrobp.2012.10.014","article-title":"Hedgehog pathway inhibition radiosensitizes non-small cell lung cancers","volume":"86","author":"Zeng","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Clinical and Experimental Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ced\/advance-article-pdf\/doi\/10.1093\/ced\/llae068\/57687230\/llae068.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/49\/9\/1024\/58892920\/llae068.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ced\/article-pdf\/49\/9\/1024\/58892920\/llae068.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T04:21:52Z","timestamp":1724386912000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ced\/article\/49\/9\/1024\/7619215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":25,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,3,5]]},"published-print":{"date-parts":[[2024,8,22]]}},"URL":"https:\/\/doi.org\/10.1093\/ced\/llae068","relation":{},"ISSN":["0307-6938","1365-2230"],"issn-type":[{"value":"0307-6938","type":"print"},{"value":"1365-2230","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,9]]},"published":{"date-parts":[[2024,3,5]]}}}