title: Advanced basal cell carcinoma of the skin: targeting the hedgehog pathway.
abstract: OBJECTIVE
  This article provides an update on basal cell carcinoma (BCC), with a focus on the advanced BCC (aBCC), and the recent progress with targeted hedgehog signaling pathway inhibition for treatment of aBCC.
  
  
  RESULTS
  The hedgehog signaling pathway is aberrantly activated in most BCC tumors providing an attractive therapeutic target in this cancer. Recently developed targeted hedgehog pathway inhibitors have demonstrated remarkable efficacy in the treatment of aBCC and the first oral hedgehog pathway inhibitor vismodegib was granted the US Food and Drug Administration (FDA) approval. Toxicities of the current hedgehog pathway inhibitors are mostly mild to moderate, but with prolonged treatment can pose a therapeutic challenge.
  
  
  CONCLUSIONS
  Hedgehog pathway inhibition is a novel and powerful approach for treatment of aBCC. Current research efforts aim to enhance the activity and minimize toxicity of this promising new therapy.
authors.affiliation: Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA. sekulic.aleksandar@mayo.edu
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sekulic
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Mangold
authors.forename: Donald W
authors.initials: DW
authors.lastname: Northfelt
authors.forename: Patricia M
authors.initials: PM
authors.lastname: LoRusso
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology*; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000378:metabolism*; D053823:Hedgehog Proteins / Q000037:antagonists & inhibitors* / Q000378:metabolism*; D006801:Humans; D058990:Molecular Targeted Therapy; D015398:Signal Transduction / Q000187:drug effects; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents; D053823:Hedgehog Proteins