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Harnessing hedgehog for the treatment of basal cell carcinoma.

Vismodegib, a first-in-class small-molecule hedgehog pathway inhibitor, was approved by the Food and Drug Administration in January 2012 for the treatment of metastatic and locally advanced basal cell carcinoma (BCC). The commentary by Wysong et al1 in this issue of JAMA Dermatology highlights the poor response of metastatic BCC to conventional forms of therapy, making hedgehog pathway antagonists an important addition to the therapeutic armamentarium for this rare but deadly type of BCC.