Department of Onco-Hematology, Unit of Medical Oncology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy.
Department of Onco-Hematology, Oncologic Dermatology Unit, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), IRCCS-CROB, 85028 Rionero in Vulture, Italy.
Int J Mol Sci. 2020 Nov 14;21(22):8596. doi: 10.3390/ijms21228596.
Cutaneous basal cell carcinoma (BCC) is the most common type of human tumor, and its incidence rate is increasing worldwide. Up until a few years ago, therapeutic options have been limited for patients with advanced BCC (including metastatic and locally-advanced BCC). Over the last few years, promising systemic therapies have been investigated for the treatment of advanced BCC. In particular, the Hedgehog signaling inhibition has shown remarkable results for this population. Hedgehog inhibitors, represented by vismodegib and sonidegib, have been approved by the Food and Drug Administration and the European Medicines Agency for the treatment of both locally advanced and metastatic BCC, with, generally, a good safety profile. Notwithstanding the late onset of BCC in the global population, associated with life expectancy increase, only a few clinical trials have evaluated the efficacy and safety profile of Hedgehog inhibitors in this complex and neglected population. Herein, we review the major mechanisms implicated in the pathogenesis of BCC focusing on the Hedgehog signaling pathway and its therapeutic role in the elderly population. Finally, we report two case reports of BCC elderly patients in order to demonstrate both efficacy and safety of the Hedgehog inhibitors.
皮肤基底细胞癌 (BCC) 是最常见的人类肿瘤类型，其发病率在全球范围内呈上升趋势。直到几年前，晚期 BCC（包括转移性和局部晚期 BCC）患者的治疗选择还很有限。在过去的几年中，已经研究了有前途的系统疗法来治疗晚期 BCC。特别是 Hedgehog 信号抑制在这一人群中显示出显著的效果。Hedgehog 抑制剂，以 vismodegib 和 sonidegib 为代表，已被美国食品和药物管理局和欧洲药品管理局批准用于治疗局部晚期和转移性 BCC，通常具有良好的安全性。尽管全球人口的 BCC 发病较晚，与预期寿命的增加有关，但只有少数临床试验评估了 Hedgehog 抑制剂在这一复杂和被忽视的人群中的疗效和安全性。在此，我们回顾了 BCC 发病机制中涉及的主要机制，重点介绍 Hedgehog 信号通路及其在老年人群中的治疗作用。最后，我们报告了两例老年 BCC 患者的病例报告，以证明 Hedgehog 抑制剂的疗效和安全性。
