[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-142045-en":3,"doc-seo-142045-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},142045,1099514068365,"Aurelia","https://ap-avatar.wpscdn.com/avatar/10000253d8d9f28188e?_k=1776742907772140068",7,"Healthcare","Treatment of locally advanced and metastatic basosquamous carcinoma - Review article - case series and literature review","Locally advanced (laBSCs) and metastatic basosquamous carcinomas (mBSCs) pose major therapeutic challenges because they are typically not suitable for surgery or radiotherapy. Published evidence describes use of sonic hedgehog pathway inhibitors, anti-PD-1 agents, and multimodal approaches including chemotherapy, surgery, and radiotherapy. The article presents 5 real-life advanced cases treated in Trieste and reviews literature data totaling 17 patients, suggesting sonic hedgehog inhibitors may work as first-line options while anti-PD-1 cemiplimab could support second-line treatment.","Received: 27 June 2023  \nRevised: 24 September 2023  \nAccepted: 18 October 2023  \nDOI: 10.1111/ajd.14182  \nREVIEW ARTICLE  \nTreatment of locally advanced and metastatic basosquamous carcinoma, navigating among sonic hedgehog pathway inhibitors, immune checkpoint inhibitors, chemotherapy, and radiotherapy: A case series and literature review  \nEnrico Zelin MD1  | Vanessa Mazzoletti MD2  | Francesco Cavallo MD3  | Carlotta Nardello MD1 | Andrea Corio MD1 | Ludovica Toffoli MD1  |  \nLuca Tagliaferri MD, PhD4 | Claudio Conforti MD1,5  | Nicola Di Meo MD1  | Iris Zalaudek MD1   \n1Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy  \n2Department of Health Science, University of Eastern Piedmont, Novara, Italy  \n3Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy  \n4UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologicaed Ematologia, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy  \n5Dermatological Research Hospital, IDI IRCCS, Rome, Italy  \nCorrespondence  \nEnrico Zelin, Dermatology Clinic, Maggiore Hospital, Piazza dell'Ospitale 1, Trieste 34129, Italy.  \nEmail: [enrico.zelin@gmail.com](enrico.zelin@gmail.com)  \nAbstract  \nLocally advanced (laBSCs) and metastatic basosquamous carcinomas (mBSCs) represent a therapeutic challenge. By definition, these forms are not amenable to surgery or radiotherapy, but according to literature reports, sonic hedgehog pathway inhibitors (HHIs), anti-programmed death 1 receptor antibodies (antiPD-1), and other treatment approaches involving chemotherapy, surgery, and radiotherapy have been used. This work features 5 real-life cases of advanced BSCs, treated at the Dermato-Oncology Unit of Trieste (Maggiore Hospital, University of Trieste) . In addition, a review of the current treatment options reported in the literature for laBSC and mBSC is provided, collecting a total of 17 patients. According to these preliminary data, HHIs such as sonidegib and vismodegib could represent a safe and effective first line of treatment, while the anti-PD-1 cemiplimab may be useful as a second-line option. Chemotherapy and combined approaches involving surgery and radiotherapy have been also reported to be suitable in some patients.  \nKEYWORDS  \ncemiplimab, chemotherapy, locally advanced basosquamous carcinoma, metastatic basosquamous carcinoma, nivolumab, radiotherapy, review, sonic hedgehog pathway inhibitors, sonidegib, surgery, treatment, vismodegib  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2023 The Authors. Australasian Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Australasian College of Dermatologists.  \n104  \n|  \nZELIN et al.  \nINTRODUCTION  \nCutaneous basosquamous carcinoma (BSC) is a rare variant of basal cell carcinoma with areas of squamous differentiation, characterized by aggressive local growth and metastatic potential. Locally advanced BSC (laBSC) is defined as a BSC not amenable to surgery or radiotherapy.1  \nTo date, no standard therapy for laBSC or metastatic BSC (mBSC) has been established, although many treatment possibilities have been described, including sonic hedgehog pathway inhibitors (HHIs), immune checkpoint inhibitors (ICIs) as anti-programmed death 1 (anti-PD-1) receptor antibodies, chemotherapy, and combined approaches involving surgery and radiotherapy (RT) .2,3  \nThis work provides a review of the treatment options reported in the literature for laBSC and mBSC, together with the description of 5 real-life cases of advanced BSCs, treated at Dermato-Oncology Unit of Trieste (Maggiore Hospital, University of Trieste) .  \nMETHODS  \nFor this review, a search of PubMed, [Science.gov](Science.gov), and [ClinicalTrials.gov](ClinicalTrials.gov) databases has been performed,","cbCairKXBxjbfZ7i","https://ap.wps.com/l/cbCairKXBxjbfZ7i","pdf",1868190,1,11,"English","en",105,"# Introduction\n# Methods\n# Results\n## Sonic HHIs\n## Immune checkpoint inhibitors (anti-PD-1)\n## Chemotherapy and radiotherapy\n## Combined approaches\n# Discussion","[{\"question\":\"Why are locally advanced and metastatic basosquamous carcinomas difficult to treat?\",\"answer\":\"By definition, these cases are not amenable to surgery or radiotherapy in many situations, so effective systemic and/or multimodal strategies are needed.\"},{\"question\":\"Which treatment classes are reviewed for laBSC and mBSC?\",\"answer\":\"The review covers sonic hedgehog pathway inhibitors, immune checkpoint inhibitors targeting anti-PD-1, chemotherapy, and combinations that may include surgery and radiotherapy.\"},{\"question\":\"What does the article suggest about first-line and second-line therapy based on the preliminary data?\",\"answer\":\"Sonic hedgehog inhibitors such as sonidegib and vismodegib are proposed as potential safe and effective first-line options, while cemiplimab (anti-PD-1) may be useful as a second-line option. \"}]","Treatment of locally advanced and metastatic basosquamous carcinoma - Review article - case series and literature review | PDF",1787673731,28,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":28},"treatment-of-locally-advanced-and-metastatic-basosquamous-carcinoma-review-article-case-series-and-literature-review","",{"@graph":36,"@context":86},[37,54,69],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/treatment-of-locally-advanced-and-metastatic-basosquamous-carcinoma-review-article-case-series-and-literature-review/142045/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":23,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-08-27","2026-08-25",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"Why are locally advanced and metastatic basosquamous carcinomas difficult to treat?","Question",{"text":76,"@type":77},"By definition, these cases are not amenable to surgery or radiotherapy in many situations, so effective systemic and/or multimodal strategies are needed.","Answer",{"name":79,"@type":74,"acceptedAnswer":80},"Which treatment classes are reviewed for laBSC and mBSC?",{"text":81,"@type":77},"The review covers sonic hedgehog pathway inhibitors, immune checkpoint inhibitors targeting anti-PD-1, chemotherapy, and combinations that may include surgery and radiotherapy.",{"name":83,"@type":74,"acceptedAnswer":84},"What does the article suggest about first-line and second-line therapy based on the preliminary data?",{"text":85,"@type":77},"Sonic hedgehog inhibitors such as sonidegib and vismodegib are proposed as potential safe and effective first-line options, while cemiplimab (anti-PD-1) may be useful as a second-line option.","https://schema.org",{"og:url":52,"og:type":88,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":90,"canonical":52},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":93},[94,98,102,106,111,116,119,124,129,132,136],{"id":20,"doc_module":4,"doc_module_name":46,"category_name":95,"show_sort_weight":96,"slug":97},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":99,"show_sort_weight":100,"slug":101},"Literature",80,"literature",{"id":53,"doc_module":4,"doc_module_name":46,"category_name":103,"show_sort_weight":104,"slug":105},"Exam",70,"exam",{"id":107,"doc_module":4,"doc_module_name":46,"category_name":108,"show_sort_weight":109,"slug":110},5,"Comic",60,"comic",{"id":112,"doc_module":4,"doc_module_name":46,"category_name":113,"show_sort_weight":114,"slug":115},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":117,"slug":118},40,"healthcare",{"id":120,"doc_module":4,"doc_module_name":46,"category_name":121,"show_sort_weight":122,"slug":123},8,"Research & Report",30,"research-report",{"id":125,"doc_module":4,"doc_module_name":46,"category_name":126,"show_sort_weight":127,"slug":128},9,"Religion & Spirituality",20,"religion-spirituality",{"id":127,"doc_module":4,"doc_module_name":46,"category_name":130,"show_sort_weight":127,"slug":131},"World Cup","world-cup",{"id":133,"doc_module":4,"doc_module_name":46,"category_name":134,"show_sort_weight":133,"slug":135},10,"Lifestyle","lifestyle",{"id":137,"doc_module":4,"doc_module_name":46,"category_name":138,"show_sort_weight":107,"slug":139},19,"General","general"]