ITRACONAZOLE BEYOND FUNGUS: TARGETING THE HEDGEHOG IN RECURRENT BASAL CELL CARCINOMA – A CASE STUDY

Basal cell carcinoma (BCC) is the most prevalent form of skin cancer, often managed by surgical excision. However, recurrent cases pose a significant therapeutic challenge, necessitating exploration of novel target intervention. Recent clinical evidence highlights the role of Hedgehog (Hh) signalling pathway in the pathogenesis of BCC. CASE PRESENTATION: A 68-year-old female patient was developed with BCC of left parotid gland and underwent a surgical treatment for two times, and yet experience a tumor relapse. In view of aggressive tumor recurrence and limited surgical benefit, itraconazole- an antifungal drug with off-label anticancer potential was considered. FINDINGS: Itraconazole in treatment of BCC exhibit a dual advantage by inhibiting Hedgehog signalling pathway by supressing Smoothened protein activity, thereby disrupting tumour cell proliferation and it is economically affordable and accessible compared to currently available Hedgehog pathway inhibitors like vismodegib, sonidegib. CONCLUSION: This case underscores the significance of drug repurposing in oncology. The use of itraconazole in recurrent BCC highlights a therapeutic avenue, in resource limited settings. Its integration into oncology practice exemplifies drug repurposing, bridging pharmacology with personalised cancer care.