title: Basal cell carcinoma: a paradigm for targeted therapies.
abstract: BACKGROUND
  Basal cell carcinoma (BCC) is the most frequent cancer with increasing incidence over the last decades. Standard of care is surgical excision, upon which complete tumour clearance is achieved in most cases. However, a small subgroup of patients will have remnants of disease post-excision and require further treatment options. Over 90% of all BCCs carry a mutation in PTCH 1 or SMO, two conducting proteins of the Hedgehog pathway (Hh). Therefore, inhibition of the Hh pathway is a promising option for systemic first-line therapy. Vismodegib was the first developed of these small molecules, which was approved by the FDA in January 2012.
  
  
  METHODS
  The authors review current treatment modalities for BCC and discuss current developments in pharmacological therapy. The current literature including meta-analyses, the Cochrane database and registered as well as completed randomized controlled trials.
  
  
  CONCLUSIONS
  Hh inhibitors are a new promising treatment option for patients with advanced or metastatic BCC. Phase I and II clinical trials with the Hh inhibitor, vismodegib, showed a significant reduction in tumour size and appearance of new tumours with relatively good tolerability. Nevertheless, further investigation on new molecules and the effectiveness of an intermittent dosing regimen is necessary.
authors: University Hospital Zurich, Department of Dermatology, Gloriastrasse 31, CH-8091 Zurich, Switzerland.
authors: Jil
authors: J
authors: Dreier
authors: Lea
authors: L
authors: Felderer
authors: Marjam
authors: M
authors: Barysch
authors: Sima
authors: S
authors: Rozati
authors: Reinhard
authors: R
authors: Dummer
mesh_terms: D000813:Anilides / Q000627:therapeutic use; D000818:Animals; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D019008:Drug Resistance, Neoplasm; D053823:Hedgehog Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism; D006801:Humans; D011725:Pyridines / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology / Q000628:therapy*
chemical_list: D000813:Anilides; D053823:Hedgehog Proteins; C538724:HhAntag691; D011725:Pyridines