Neoadjuvant Hedgehog Inhibitors: Gaining Ground in Mohs for BCC?
A recent survey of American College of Mohs Surgery members reveals that 22% of Mohs surgeons are already using hedgehog pathway inhibitors preoperatively in basal cell carcinoma (BCC) cases. This neoadjuvant approach, aimed at shrinking tumors before surgery, offers both cosmetic and functional benefits, particularly for large or complex lesions.
The survey showed wide variability in how these therapies are used: tumor size, location, duration, and reduction goals all differed. While short-course treatment may improve tolerability, key barriers to wider adoption remain, including concerns over adverse effects and the risk of leaving discontinuous tumor for excision.
Takeaway: Neoadjuvant hedgehog inhibitors are emerging as a strategic option in select BCC cases—especially when balancing surgical outcomes with patient safety.
Looking for further expert guidance? A recent consensus panel of dermatologic oncology leaders reviewed the efficacy and safety of hedgehog inhibitors in advanced BCC and underscored their value in both primary and neoadjuvant settings—particularly when surgical outcomes or function are at stake. You can read more about that article here.
