Skip to main content
Journal cover image

Outcomes of adjunctive therapies post hedgehog inhibitors in the management of locally advanced basal cell carcinoma: A systematic review and pooled analysis.

Publication ,  Journal Article
Patel, A; Kim, JS; Liss, J; Howard, L; Jung, S-H; Kheterpal, M
Published in: Dermatol Ther
November 2021

Management of patients with locally advanced basal cell carcinoma (laBCC) with traditional strategies has yielded suboptimal outcomes. Targeted treatments including hedgehog inhibitor therapy (HHIT) present limitations when utilized as monotherapy. Herein, we report evidence-based outcomes from available literature on multimodality treatments adjuvant to HHIT in laBCC management. Utilizing a systematic search strategy in PubMed, we identified studies published from inception to April 15, 2020, screened for definitive inclusion/exclusion criteria, and performed individual study quality assessment and pooled analysis to assess impact of adjunctive treatment-based responses post-HHIT on clinical response and recurrence outcomes. Twenty-nine studies (n = 103) were included. Primary findings include a complete response (CR) rate of 90.5%, the median follow-up of 12 months post-HHIT completion. The recurrence rate was 10.8% with 12-month median time to recurrence. Mohs micrographic surgery (MMS) had 100% CR post-HHIT, while no difference was observed between surgery and radiation therapy (RT). MMS and surgery had comparable 2-year recurrence free rates (RFR) at 87% and 86% respectively, while RT had the lower 2-year RFR at 67%. Male gender portended a more advanced stage at diagnosis and worse outcomes. In a subset analysis, periorbital laBCCs with orbital involvement had a CR rate of 81.8% versus 100% in those without orbital involvement, with similar rates of recurrence. Limited available quantitative data and possible publication bias were limitations. Pooled analysis of observational data supports use of adjunctive therapies post-HHIT to improve treatment response in patients with laBCC. Longer-term follow-up is needed to study recurrence rates after combination therapy.

Duke Scholars

Published In

Dermatol Ther

DOI

EISSN

1529-8019

Publication Date

November 2021

Volume

34

Issue

6

Start / End Page

e15172

Location

United States

Related Subject Headings

  • Skin Neoplasms
  • Pyridines
  • Male
  • Humans
  • Hedgehog Proteins
  • Dermatology & Venereal Diseases
  • Carcinoma, Basal Cell
  • Antineoplastic Agents
  • Anilides
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Patel, A., Kim, J. S., Liss, J., Howard, L., Jung, S.-H., & Kheterpal, M. (2021). Outcomes of adjunctive therapies post hedgehog inhibitors in the management of locally advanced basal cell carcinoma: A systematic review and pooled analysis. Dermatol Ther, 34(6), e15172. https://doi.org/10.1111/dth.15172
Patel, Arsh, Jane S. Kim, Jason Liss, Lauren Howard, Sin-Ho Jung, and Meenal Kheterpal. “Outcomes of adjunctive therapies post hedgehog inhibitors in the management of locally advanced basal cell carcinoma: A systematic review and pooled analysis.Dermatol Ther 34, no. 6 (November 2021): e15172. https://doi.org/10.1111/dth.15172.
Patel, Arsh, et al. “Outcomes of adjunctive therapies post hedgehog inhibitors in the management of locally advanced basal cell carcinoma: A systematic review and pooled analysis.Dermatol Ther, vol. 34, no. 6, Nov. 2021, p. e15172. Pubmed, doi:10.1111/dth.15172.
Journal cover image

Published In

Dermatol Ther

DOI

EISSN

1529-8019

Publication Date

November 2021

Volume

34

Issue

6

Start / End Page

e15172

Location

United States

Related Subject Headings

  • Skin Neoplasms
  • Pyridines
  • Male
  • Humans
  • Hedgehog Proteins
  • Dermatology & Venereal Diseases
  • Carcinoma, Basal Cell
  • Antineoplastic Agents
  • Anilides
  • 3202 Clinical sciences