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Sonic Hedgehog Pathway Inhibition in the Treatment of Advanced Basal Cell Carcinoma

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Book cover Biologic and Systemic Agents in Dermatology

Abstract

Basal cell carcinoma (BCC) typically presents as an indolent, locally invasive cutaneous tumor that can be managed effectively with various techniques, including surgery, topical therapies, and radiation. Advanced basal cell carcinoma represents a small proportion of cases that are not amenable to standard therapies due to lack of efficacy, high risk of recurrence, and excessive morbidity. Implication of the Sonic hedgehog (Shh) pathway in the development of BCC has led to the development of novel systemic Shh pathway inhibitors, providing patients with advanced BCCs new treatment options and improved survival. The primary target of the currently approved Shh inhibitors is through inhibition of the smoothened (SMO) protein. The efficacy of long-term treatment with SMO inhibitors can be mitigated through development of tumor resistance through multiple mechanisms. Potential directions for long-term therapy with Shh pathway inhibition may include switching or combining therapies with medications that possess different mechanisms of action.

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Author information

Authors and Affiliations

  1. Division of Dermatology, UCLA Medicine, Los Angeles, CA, USA

    Patrick Armstrong MD

  2. UCLA/WLA VA Derm Surgery Fellowship Program, Dermatologic Surgery and Mohs Micrographic Surgery, Department of Dermatology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

    Stephanie Martin MD

  3. Dermatology Laser Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Gary Lask MD

Authors
  1. Patrick Armstrong MD
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  2. Stephanie Martin MD
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  3. Gary Lask MD
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Corresponding author

Correspondence to Stephanie Martin MD .

Editor information

Editors and Affiliations

  1. Division of Dermatology, David Geffen School of Medicine a UCLA, Los Angeles, California, USA

    Paul S. Yamauchi

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Armstrong, P., Martin, S., Lask, G. (2018). Sonic Hedgehog Pathway Inhibition in the Treatment of Advanced Basal Cell Carcinoma. In: Yamauchi, P. (eds) Biologic and Systemic Agents in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-66884-0_47

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  • DOI: https://doi.org/10.1007/978-3-319-66884-0_47

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66883-3

  • Online ISBN: 978-3-319-66884-0

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