Journal of the American Academy of Dermatology
Original articleEfficacy, safety, and comparison of sonic hedgehog inhibitors in basal cell carcinomas: A systematic review and meta-analysis
Section snippets
Systematic review
This systematic review and meta-analysis followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.17 The study protocol was published prospectively by GitHub Inc (https://github.com/plefrancois/Meta_BCC_SHHi). Our search goal was to retrieve all studies involving the treatment of BCC with SHHis. We used ClinicalTrials.gov to determine which SHHis had been used to treat BCC. We performed a broad search in PubMed, ClinicalTrials.gov, Embase, and Cochrane
Systematic review
This study's flow diagram is shown in Supplemental Fig 1 (available at http://www.jaad.org). Fourteen studies focused on vismodegib,4, 12, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32 2 on sonidegib,14, 33, 34 1 on itraconazole,16 and 1 on TAK-441.15 Table I presents efficacy data and Table II safety data for individual studies. Across all studies, median drug exposure ranged 1.3-21 (median 5.25) months and median follow-up time 1.3-36 (median 11) months.
Bias assessment
Among the 18 studies, 13 were
Discussion
Our meta-analysis reveals that clinicians should expect partial responses in laBCC with vismodegib or sonidegib treatment. Compared with sonidegib, vismodegib had a higher ORR and CRR for laBCC and higher ORR for mBCC. Moreover, sonidegib caused more upper gastrointestinal disturbances and myalgias than vismodegib. These findings favor the use of vismodegib over sonidegib in clinical practice. One small study reported that sequential therapy with sonidegib for vismodegib-resistant BCC is
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Cited by (0)
Drs Xie and Lefrançois contributed to this work equally.
Funding sources: Partly supported by the Canadian Dermatology Foundation.
Conflicts of interest: None disclosed.
Reprints not available from the authors.