vismodegib vismodegib vismodegib, sold under the brand name erivedge, is a medication used for the treatment of basal-cell carcinoma (bcc). the approval of vismodegib on january 30, 2012, represents the first hedgehog signaling pathway targeting agent to gain u.s. food and drug administration (fda) approval. the drug is also undergoing clinical trials for metastatic colorectal cancer, small-cell lung cancer, advanced stomach cancer, pancreatic cancer, medulloblastoma and chondrosarcoma as of june 2011. the drug was developed by the biotechnology/pharmaceutical company genentech. vismodegibclinical datapronunciation/ˌvɪsmoʊˈdɛɡɪb/vis-moh-deg-ib trade nameserivedgeother namesgdc-0449, rg-3616ahfs/drugs.commonographlicense data eu ema: by inn us fda: vismodegib pregnancycategory au: x (high risk) routes ofadministrationby mouthatc codel01xj01 (who) legal statuslegal status au: s4 (prescription only) ca: ℞-only uk: pom (prescription only) us: ℞-only eu: rx-only pharmacokinetic databioavailability31.8%protein binding>99%metabolism<2% metabolised by cyp2c9, cyp3a4, cyp3a5elimination half-life4 days (continuous use),12 days (single dose)excretionfecal (82%), urinary (4.4%)identifiers iupac name 2-chloro-n-(4-chloro-3-pyridin-2-ylphenyl)-4-methylsulfonylbenzamide cas number879085-55-9pubchem cid24776445iuphar/bps6975drugbankdb08828chemspider23337846unii25x868m3dskeggd09992chebichebi:66903 ychemblchembl473417comptox dashboard (epa)dtxsid40236689 echa infocard100.234.019 chemical and physical dataformulac19h14cl2n2o3smolar mass421.29 g·mol−13d model (jsmol)interactive image smiles cs(=o)(=o)c1=cc(=c(c=c1)c(=o)nc2=cc(=c(c=c2)cl)c3=cc=cc=n3)cl inchi inchi=1s/c19h14cl2n2o3s/c1-27(25,26)13-6-7-14(17(21)11-13)19(24)23-12-5-8-16(20)15(10-12)18-4-2-3-9-22-18/h2-11h,1h3,(h,23,24)key:bpqmgsktayivfo-uhfffaoysa-n indication vismodegib is indicated for people with basal-cell carcinoma (bcc) which has metastasized to other parts of the body, relapsed after surgery, or cannot be treated with surgery or radiation. mechanism of action the substance acts as a cyclopamine-competitive antagonist of the smoothened receptor (smo) which is part of the hedgehog signaling pathway. smo inhibition causes the transcription factors gli1 and gli2 to remain inactive, which prevents the expression of tumor mediating genes within the hedgehog pathway. this pathway is pathogenetically relevant in more than 90% of basal-cell carcinomas. side effects in clinical trials, common side effects included gastrointestinal disorders (nausea, vomiting, diarrhoea, constipation), muscle spasms, fatigue, hair loss, and dysgeusia (distortion of the sense of taste). development vismodegib has undergone several promising phase i and phase ii clinical trials for its use in treating medulloblastoma.