A Review of Hedgehog Inhibitors Sonidegib and Vismodegib for Treatment of Advanced Basal Cell Carcinoma

The document reviews the efficacy and safety of sonidegib and vismodegib, two Hedgehog pathway inhibitors used for treating advanced basal cell carcinoma (BCC). It presents data showing similar efficacy between the drugs in terms of objective response rates and adverse events, such as muscle spasms, alopecia, and dysgeusia. Sonidegib showed a 56% response rate in aggressive BCC and 52% in nonaggressive BCC at 200 mg, with slightly better safety profiles than vismodegib. Vismodegib demonstrated a reduction in the rate of new BCCs compared to placebo. Both drugs have issues with resistance, and ongoing research is needed for managing BCC, particularly in patients with nevoid basal cell carcinoma syndrome (NBCCS) and those who develop resistance to these treatments.