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September 5, 2026CancersOpen Access

Reflectance Confocal Microscopy for Treatment Response Monitoring in Locally Advanced Basal Cell Carcinoma Treated with Sonidegib: A Prospective Observational Study

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Authors

FVFederico VenturiCBCarlotta BaraldiBCBarbara Corti

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Overview

Observational study reveals reflectance confocal microscopy detects residual tumor missed by clinical exams in advanced basal cell carcinoma, highlighting its utility for treatment monitoring.

Key Points

  • Evaluate reflectance confocal microscopy for monitoring treatment response and guiding presurgical planning in patients with locally advanced basal cell carcinoma treated with sonidegib.
  • Prospective, single-center observational pilot study of 15 consecutive patients with locally advanced basal cell carcinoma unsuitable for initial surgery receiving sonidegib 200 mg daily.
  • Assessed tumor response at baseline and follow-up using integrated clinical examination and reflectance confocal microscopy adapted from RECIST guidelines, with presurgical mapping and dual-reader blinded agreement analysis.
  • The objective response rate was 93.3% (complete response: 26.7%, partial response: 66.7%, progressive disease: 6.7%), with adverse events occurring in 60.0% and dose modifications required in 73.3% of patients.
  • Clinical–confocal discordance occurred in 13.3% of patients, where microscopic detection of persistent basaloid nests reclassified clinical complete responses into partial responses, guiding treatment continuation (interobserver κ = 0.62–0.86).

Cite This Study

Venturi et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd4216b95aff0620eb987https://doi.org/10.3390/cancers18172858
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