# Clinical Outcomes of Sonidegib in Vismodegib‐Exposed Locally Advanced Basal Cell Carcinoma: Insights From a Multicenter Descriptive Study

## TL;DR

Sonidegib shows promise as a second-line treatment for advanced basal cell carcinoma after prior vismodegib use.

## Contribution

This study provides real-world evidence of sonidegib's efficacy in patients previously treated with vismodegib.

## Key findings

- 11 out of 12 patients achieved disease control with sonidegib.
- Two patients had complete response and nine had partial response.
- No new adverse events were observed with sonidegib.

## Abstract

Locally advanced basal cell carcinoma represents a therapeutic challenge, especially if already exposed to hedgehog (Hh) pathway inhibitor (HPI) therapy. Effectiveness after switching to another HPI still requires exploration.

This observational, descriptive study retrospectively evaluates the clinical outcomes of sonidegib in patients with vismodegib‐treated locally advanced basal cell carcinoma in a real‐world, multicenter cohort across nine centers. Twelve patients with histologically aggressive locally advanced basal cell carcinoma previously exposed to vismodegib for at least 3 months were analyzed. Each received sonidegib at a standard dosage. Treatment response was assessed clinically according to tumor size changes and classified as complete response (100% decrease), partial response (at least 50% decrease), stable disease (up to 20% increase or less than 50% decrease), or disease progression (at least 20% increase). Adverse events (AEs) were documented.

Two patients achieved complete clinical response, nine demonstrated partial response, and one exhibited disease progression. Disease control was achieved in 11 of the 12 patients (91.7%). No novel AEs have been documented, and they were managed through dose adjustments or temporary interruptions.

These findings suggest that sonidegib could still show efficacy and may still serve as a viable second‐line option after prior Hh pathway suspension.