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

Background: 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. Methods: 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. Results: 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. Conclusion: These findings suggest that sonidegib could still show efficacy and may still serve as a viable second-line option after prior Hh pathway suspension.