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Sonidegib in Basal Cell Carcinoma: Half the Dose, Equal Results, Better Toxicity?

By: Celeste L. Dixon
Posted: Wednesday, February 17, 2021

Treating patients with locally advanced basal cell carcinoma with an alternate dosing regimen of sonidegib—200 mg of the Hedgehog inhibitor every other day, rather than daily—may reduce the degree and frequency of adverse effects. This would likely improve patients’ compliance and adherence to treatment, reported Massimiliano Scalvenzi, MD, of the University of Naples Federico II, Italy, and colleagues, without decreasing its efficacy.

The team published a retrospective case series with this alternate regimen in the Journal of the American Academy of Dermatology. The novel agent is approved for adult patients whose disease recurs after other treatments or who are not candidates for surgery or radiotherapy.

“Muscle spasms (71.2%), alopecia (66.3%), dysgeusia (55.8%), and weight loss (50%) are the adverse effects most frequently experienced [with sonidegib] and can be so severe as to cause treatment discontinuation,” wrote the authors. No other studies in the literature reporting on such results of real-life alternate dosing of sonidegib have been published to their knowledge.

From January to October 2020 at the authors’ hospital, 20 patients received sonidegib to treat locally advanced basal cell carcinoma, 9 of whom were on the dose-adjusted regimen. Patients who received the dose-adjusted treatment had clinical responses comparable to those of patients who received sonidegib daily, and they experienced just mild (grade 1 or 2) adverse effects. Of the nine patients, six had a complete response, and three had a partial response, Dr. Scalvenzi and co-investigators reported.

The 20 patients’ median age at diagnosis was 77.8 years, and 2 were female. Their median duration of sonidegib treatment was 6.5 months. The authors suggested that further studies not limited by a retrospective design should be completed to further ascertain the optimal dosing schedule for sonidegib.

Disclosure: The study authors reported no conflicts of interest.

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