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DRUG CLASS:

Hedgehog cell-signalling pathway inhibitor

13d
Resistance to SMO Inhibitors in Advanced Basal Cell Carcinoma: A Case Highlighting the Role of Molecular Tumor Profiling. (PubMed, Int J Mol Sci)
Accordingly, current targeted therapies for locally advanced, unresectable, or metastatic BCC focus on SMO inhibition, using orally administered drugs such as vismodegib and sonidegib. To our knowledge, this is the first report documenting a sonidegib resistance mechanism in BCC that is independent of HH pathway mutations. This case highlights the complexity of resistance mechanisms to HH inhibitors and underscores the critical need for comprehensive molecular tumor profiling prior to initiating targeted therapy.
Journal
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TP53 (Tumor protein P53) • FGFR1 (Fibroblast growth factor receptor 1) • NOTCH1 (Notch 1) • PTCH1 (Patched 1) • SMO (Smoothened Frizzled Class Receptor)
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TP53 mutation
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Erivedge (vismodegib) • Odomzo (sonidegib)
18d
Natural products as payloads for antibody-drug conjugates: Cyclopamine linked to cetuximab for hedgehog pathway inhibition. (PubMed, Bioorg Chem)
The linker-payload system was stable in plasma yet released gradually cyclopamine at pH 5.5. These results suggest the feasibility of using natural products as payloads for the construction of ADCs to inhibit HH signalling in cancer cells.
Journal
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EGFR (Epidermal growth factor receptor) • GLI1 (GLI Family Zinc Finger 1) • GLI2 (GLI Family Zinc Finger 2)
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EGFR expression
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Erbitux (cetuximab) • cyclopamine
25d
Targeting SPP1-CD44-Hedgehog Axis Elicits Therapeutic Effects in Hepatocellular Carcinoma by Suppressing Intratumoral Fibrosis. (PubMed, Cancer Sci)
Pharmacological inhibition of GLI1 with the SMO inhibitor vismodegib suppressed HSC activation in vitro and reduced fibrosis and tumor growth in vivo. These findings indicate that SPP1 promotes intratumoral fibrosis and HCC progression through the SPP1-CD44-GLI1 axis, highlighting its potential as a prognostic biomarker and therapeutic target. Inhibition of SPP1-CD44-Hedgehog signaling may provide a promising strategy to mitigate fibrosis and improve HCC patient outcomes.
Journal
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SPP1 (Secreted Phosphoprotein 1)
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Erivedge (vismodegib)
29d
Activated T cells degrade extracellular proteins to enhance effector functions. (PubMed, Cell Rep)
This functional defect is rescued by treatment with Vismodegib, a TFE3-inducing drug. Our findings reveal lysosome-mediated extracellular protein catabolism as an important metabolic pathway supporting T cell immunity.
Journal
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CD8 (cluster of differentiation 8) • PD-1 (Programmed cell death 1) • TFE3 (Transcription Factor Binding To IGHM Enhancer 3)
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Erivedge (vismodegib)
1m
Chondrosarcoma organoids reveal SHH pathway activation driven by PTCH1 and BCOR alterations. (PubMed, Sci Rep)
Organoid-based drug sensitivity testing was conducted using vismodegib, a Sonic Hedgehog (SHH) pathway inhibitor...We established the first PDO models of chondrosarcoma that faithfully recapitulate key tumor features. These models provide a valuable preclinical platform for dissecting molecular pathogenesis and for advancing the development of targeted therapeutic strategies in this intractable malignancy.
Journal
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PTCH1 (Patched 1) • BCOR (BCL6 Corepressor)
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Erivedge (vismodegib)
1m
SONIB: A Study to Evaluate Neoadjuvant Sonidegib Followed by Surgery or Imiquimod in the Management of Basal Cell Carcinoma (clinicaltrials.gov)
P2, N=16, Completed, Melanoma Institute Australia | Recruiting --> Completed | Trial completion date: Jun 2026 --> Mar 2025 | Trial primary completion date: Jun 2026 --> Mar 2025
Trial completion • Trial completion date • Trial primary completion date
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Odomzo (sonidegib) • Zyclara (imiquimod)
2ms
SONIB: A Study to Evaluate Neoadjuvant Sonidegib Followed by Surgery or Imiquimod in the Management of Basal Cell Carcinoma (clinicaltrials.gov)
P2, N=20, Recruiting, Melanoma Institute Australia | Trial completion date: Jun 2025 --> Jun 2026 | Trial primary completion date: Jun 2025 --> Jun 2026
Trial completion date • Trial primary completion date
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Odomzo (sonidegib) • Zyclara (imiquimod)
2ms
A Clinical and Molecular Risk-Directed Therapy for Newly Diagnosed Medulloblastoma (clinicaltrials.gov)
P2, N=660, Active, not recruiting, St. Jude Children's Research Hospital | Trial completion date: Jan 2028 --> Oct 2031 | Trial primary completion date: Nov 2025 --> Oct 2028
Trial completion date • Trial primary completion date
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cisplatin • gemcitabine • cyclophosphamide • pemetrexed • vincristine • Erivedge (vismodegib)
3ms
Mechanistic insights into pharmacokinetic interactions between simvastatin and vismodegib: Implications for optimization of combination therapy in medulloblastoma. (PubMed, Biochem Biophys Res Commun)
Taken together, these findings establish a mechanistic foundation for a proposed therapeutic optimization strategy: Reducing vismodegib dosing while leveraging its inhibition-driven elevation of simvastatin systemic/tissue exposure, thereby mitigating dose-limiting skeletal toxicity while maintaining anti-tumor efficacy. This mechanism-based strategy provides a clinically actionable framework for pediatric medulloblastoma with urgent unmet therapeutic needs.
PK/PD data • Journal
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SLCO1B1 (Solute Carrier Organic Anion Transporter Family Member 1B1)
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Erivedge (vismodegib) • simvastatin
3ms
A case of basal cell nevus syndrome with a SUFU mutation. (PubMed, Dermatol Online J)
Rarely, this condition is related to a suppressor of fused gene mutation, which occurs downstream from Smoothened, and is unresponsive to Smoothened inhibitors including vismodegib and sonidegib. Genetic testing was negative for patched 1 and patched 2 mutations but positive for a heterozygous suppressor of fused mutation. Patients with basal cell nevus syndrome should be treated with surgical excision, counseled on sun protection, screened and monitored for complications, and treated with vismodegib (if associated with patched 1 mutation) or itraconazole (if associated with suppressor of fused mutation).
Journal
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PTCH1 (Patched 1) • SUFU (SUFU Negative Regulator Of Hedgehog Signaling)
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Erivedge (vismodegib) • Odomzo (sonidegib) • itraconazole
3ms
PersoMed-I: Personalized Risk-Adapted Therapy in Post-Pubertal Patients With Newly-Diagnosed Medulloblastoma (clinicaltrials.gov)
P2, N=20, Terminated, European Organisation for Research and Treatment of Cancer - EORTC | Trial completion date: Dec 2025 --> Sep 2025 | Active, not recruiting --> Terminated | Trial primary completion date: Dec 2025 --> Jun 2025; Poor accrual
Trial completion date • Trial termination • Trial primary completion date
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TP53 (Tumor protein P53) • BRCA2 (Breast cancer 2, early onset) • MYCN (MYCN Proto-Oncogene BHLH Transcription Factor)
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TP53 wild-type
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cisplatin • vincristine • lomustine • Odomzo (sonidegib)
3ms
Solasodine inhibited the proliferation of gastric cancer cells through suppression of Hedgehog/Gli1 signaling. (PubMed, Food Sci Biotechnol)
Solasodine inhibited the proliferation of AGS and MKN74 gastric cancer cells and regulated cell cycle (Cyclin D1 and p27) and apoptosis (Bax and Bcl-2) markers in a dose-dependent manner, consistent with the Gli1/2 inhibitor Gant61 but not the Smo inhibitor vismodegib...Moreover, solasodine inhibited Gli1 rather than Smo expression in Hh signaling overexpressed Ptch (-/-) MEF cells. Our findings demonstrate that solasodine inhibits gastric cancer proliferation by targeting Hh/Gli1 signaling, underscoring its potential as a potent agent for prevention and/or inhibition of gastric cancer.
Journal • IO biomarker
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BCL2 (B-cell CLL/lymphoma 2) • CCND1 (Cyclin D1) • SMO (Smoothened Frizzled Class Receptor) • GLI1 (GLI Family Zinc Finger 1) • BAX (BCL2-associated X protein)
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Erivedge (vismodegib)