The hedgehog inhibitors (Vismodegib and Sonidegib) are used for rare cases of locally advanced and/or metastatic basal cell carcinoma (BCC).
They are also used for BCC management in Gorlin Syndrome, where appropriate and feasible.
Most BCCs are cured with surgery and the vast majority never spread.
However, rarely BCC may invade deeply into nearby muscle, cartilage and/or bone. This is called locally advanced BCC.
Even more rarely, BCC my spread to other parts of the body, such as the lymph nodes, lungs or bones. This is called metastatic BCC.
In cases whereby surgery and radiotherapy may cause significant functional and/or cosmetic deficit, or have already been performed without cure, hedgehog inhibitors may be considered.
We offer this treatment following multidisciplinary team review, in the neoadjuvant and palliative setting. Whilst this treatment can be very effective, it is not suitable for everyone.
Neoadjuvant treatment aims to shrink the tumour and ideally make surgery and/or radiotherapy easier and safer, improving the functional and cosmetic outcomes.
Palliative treatment aims to control the cancer and improve quality of life. It may stop tumour growth, shrink the tumour and relieve pain, bleeding and ulceration.
Hedgehog inhibitors may also be used in Gorlin Syndrome when multiple BCCs are developing over a short period of time, the surgical burden is overwhelming and/or for locally advanced or metastatic BCC.
Hedgehog inhibitors have potential side effects including muscle cramps, altered taste, hair thinning/loss, decreased appetite, fatigue, weight loss, kidney damage and birth defects.
Dr Caccetta and Dr Collgros administer and supervise hedgehog inhibitor treatment at Perth Dermatology Clinic.
