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EDITORIAL Harnessing Hedgehog for the Treatment of Basal Cell Carcinoma ISMODEGIB, A FIRST-IN-CLASS SMALL- molecule hedgehog pathway inhibitor, Vismodegib was approved by the Food and Drug Ad- HH Saridegib ministration in January 2012 for the treat- LDE225 BMS-833923 V ment of metastatic and locally advanced PF-04449913 LY2940680 basal cell carcinoma (BCC). The commentary by Wysong CUR61414 et al in this issue of JAMA Dermatology highlights the Cyclopamine poor response of metastatic BCC to conventional forms Itraconazole of therapy, making hedgehog pathway antagonists an im- PTCH1 SMO portant addition to the therapeutic armamentarium for this rare but deadly type of BCC. Arsenic trioxide The hedgehog signaling pathway plays critical roles GANT58 GLI GANT61 in embryonic development and is required in some adult tissues, most notably the hair follicle. Under normal con- ditions, the hedgehog pathway is repressed by the tu- Hedgehog target genes mor suppressor patched 1 (PTCH1), which blocks the proto-oncogene product smoothened (SMO) (Figure). Figure. Key components of hedgehog signaling pathway and inhibitors. Hedgehog pathway activation is initiated when secreted Physiologic signaling takes place when hedgehog (HH) binds patched 1 hedgehog ligand binds and inhibits PTCH1, leading to (PTCH1) and derepresses smoothened (SMO), leading to activation of derepression
JAMA Dermatology – American Medical Association
Published: May 1, 2013
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