{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:46:01Z","timestamp":1778651161032,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,22]],"date-time":"2021-08-22T00:00:00Z","timestamp":1629590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hedgehog inhibitor therapy (HHIT) is considered first\u2010line treatment for locally advanced, unresectable basal cell carcinoma (laBCC). HHIT often results in a partial response, which requires adjunctive therapy (AT) post HHIT. We present real\u2010world data for laBCCs undergoing HHIT\u2009\u00b1\u2009AT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review at Duke University from 11\/01\/2007 through 5\/20\/2020 revealed 13 patients treated with systemic HHIT (sonidegib or vismodegib) for laBCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen laBCCs were identified in 13 patients. LaBCCs were treated with sonidegib (<jats:italic>n<\/jats:italic>\u2009=\u200910, 71%) or vismodegib (<jats:italic>n<\/jats:italic>\u2009=\u20094, 29%) for a median (IQR) of 9.4 (9.3) or 9.8 (8.5) months, respectively. The median (IQR) follow\u2010up time from HHIT initiation was 15.5 (8.7) months. Tumors were most often located on the trunk (43%), followed by head and neck (29%), extremities (21%), and orbit\/periorbital area (7%). Nine laBCCs (64%) were treated with HHIT alone, of which five (36%) achieved complete response (CR), four (29%) achieved partial response (PR), and five (36%) achieved CR with combined HHIT and AT post\u2010HHIT. Duration of HHIT treatment (IQR) was 7.5 (3.5) months in the 10 CR patients, versus 15.1 (6.3) months in the four PR patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.024). Nine patients (69%) experienced adverse events from HHIT, most commonly ageusia\/dysgeusia, muscle spasms, and alopecia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As a single institutional experience, we report 10\/14 laBCCs (71%) with CRs without recurrence and 4\/14 laBCCs (29%) with PRs with HHIT\u2009\u00b1\u2009AT over median follow\u2010up of 15.5\u2009months. Longer follow\u2010up and larger cohorts evaluating responses with HHIT followed by AT are needed to substantiate our findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.15836","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T05:39:51Z","timestamp":1629697191000},"page":"118-124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hedgehog inhibitors with and without adjunctive therapy in treatment of locally advanced basal cell carcinoma"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9397-9630","authenticated-orcid":false,"given":"Akash D.","family":"Patel","sequence":"first","affiliation":[{"name":"School of Medicine Duke University Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surya","family":"Ravichandran","sequence":"additional","affiliation":[{"name":"School of Medicine Duke University Durham NC 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