{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:13:36Z","timestamp":1788495216154,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"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":[[2025,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hedgehog inhibitors (HHIs) should be offered to patients with advanced basal cell carcinoma (BCC) as a first-line treatment. Two systemic HHIs are currently available: sonidegib and vismodegib.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>As there is no head-to-head trial of sonidegib vs. vismodegib and very few comparative studies have been published, we aimed to prospectively describe our long-term approach to managing advanced BCC based on our 10\u2005years of experience with HHIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We undertook a prospective, monocentric and descriptive study in Florence, Italy. Patients who were treated with sonidegib and\/or vismodegib for advanced BCC according to the European Association of Dermato-Oncology staging system were included from January 2013 to December 2023. Epidemiological, efficacy and safety data were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study population consisted of 66 patients with a clinicopathologically confirmed diagnosis of advanced BCC. Of the 66 patients, 40 (61%) were treated with vismodegib, 19 (29%) received sonidegib and 7 (11%) were switched to sonidegib after vismodegib discontinuation. Among the 40 evaluable vismodegib-treated patients, the overall response rate (ORR) was 65%, with complete response (CR) in 28% of cases. The disease control rate was 85%. Among the 19 evaluable patients treated with sonidegib, the ORR and CR rates were 89% and 37%, respectively. Regarding patients who switched from vismodegib to sonidegib (mainly patients who had adverse events with vismodegib previously), the ORR was 71%, with CR in 43% of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The efficacy demonstrated by sonidegib is greater than reported in the pivotal studies, with an ORR of 89% (vs. 60.6%), a CR rate of 37% (vs. 22.7%) and a PR rate of 53% (vs. 37.9%). Another element of innovation was the analysis of the subgroup of patients who switched from vismodegib to sonidegib, with an ORR of 71% (CR 43%, PR 29%). This, in relation to the possibility of developing resistance during therapy with HHIs, represents a promising result, suggesting a maintenance of effectiveness of the target therapy even in patients who are not naive to it.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ced\/llaf383","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T11:33:12Z","timestamp":1755603192000},"page":"60-67","source":"Crossref","is-referenced-by-count":2,"title":["Management of advanced basal cell carcinoma with hedgehog inhibitors: a real-world prospective comparative\u00a0study"],"prefix":"10.1093","volume":"51","author":[{"given":"Federico","family":"Venturi","sequence":"first","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]},{"name":"Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]},{"name":"Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biancamaria","family":"Zuccaro","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Perillo","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cecchi","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Gaeta","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology, European Institute of Oncology, IRCCS , Milan ,","place":["Italy"]},{"name":"Department of Statistics and Quantitative Methods, University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Gandini","sequence":"additional","affiliation":[{"name":"Department of Experimental Oncology, European Institute of Oncology, IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6531-7998","authenticated-orcid":false,"given":"Vincenzo","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Health Sciences, University of Florence , Florence ,","place":["Italy"]},{"name":"Cancer Research \u2018Attilia Pofferi\u2019 Foundation , Pistoia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"2025122312173113500_llaf383-B1","doi-asserted-by":"crossref","first-page":"3011","DOI":"10.2217\/fon.15.246","article-title":"Basal cell carcinoma of the skin (part 1): epidemiology, pathology and genetic syndromes","volume":"11","author":"Correia de S\u00e1","year":"2015","journal-title":"Future Oncol"},{"key":"2025122312173113500_llaf383-B2","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1056\/NEJMc053488","article-title":"Basal-cell carcinoma","volume":"354","author":"De Giorgi","year":"2006","journal-title":"N Engl J Med"},{"key":"2025122312173113500_llaf383-B3","doi-asserted-by":"crossref","first-page":"2149","DOI":"10.1111\/jdv.17467","article-title":"Position statement on classification of basal cell carcinomas. 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