Lear John T, Dummer Reinhard, Guminski Alexander
Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Department of Dermatology, University Hospital, University of Zurich, Zurich, Switzerland.
Oncotarget. 2021 Dec 21;12(26):2531-2540. doi: 10.18632/oncotarget.28145.
Basal cell carcinoma (BCC) is the most common malignancy and form of skin cancer worldwide; advanced BCC, either as locally advanced BCC (laBCC) or metastatic BCC (mBCC), can cause substantial tissue invasion and morbidity. Until the recent availability of the hedgehog pathway inhibitors (HHIs) sonidegib and vismodegib, treatment options for advanced BCC were limited. These agents demonstrate efficacy in patients with laBCC and mBCC; however, the adverse events (AEs) associated with these agents can lead to treatment interruption or discontinuation and reduced quality of life, all of which significantly impact long-term adherence to therapy, which might affect clinical outcome. Given that most AEs are class-related effects, switching HHIs does not appear to lead to a significantly different AE profile, underscoring the importance of maintaining patients on their first HHI. Interrupting treatment of sonidegib and vismodegib does not appear to undermine the efficacy of these agents and is therefore a practical option to manage AEs in order to maintain continued treatment and disease control.
基底细胞癌（BCC）是全球最常见的恶性肿瘤和皮肤癌形式；晚期BCC，无论是局部晚期BCC（laBCC）还是转移性BCC（mBCC），都可导致大量组织侵袭和发病。在最近出现刺猬通路抑制剂（HHIs）索尼德吉和维莫德吉之前，晚期BCC的治疗选择有限。这些药物在laBCC和mBCC患者中显示出疗效；然而，与这些药物相关的不良事件（AE）可导致治疗中断或停药，并降低生活质量，所有这些都会显著影响长期治疗依从性，进而可能影响临床结果。鉴于大多数AE是类相关效应，更换HHIs似乎不会导致显著不同的AE谱，这突出了让患者持续使用第一种HHI的重要性。中断索尼德吉和维莫德吉的治疗似乎不会削弱这些药物的疗效，因此是管理AE以维持持续治疗和疾病控制的一个切实可行的选择。
