Itraconazole and Arsenic Trioxide Inhibit Hedgehog Pathway Activation and Tumor Growth Associated with Acquired Resistance to Smoothened Antagonists Academic Article uri icon


MeSH Major

  • Antineoplastic Agents
  • Arsenicals
  • Carcinoma, Basal Cell
  • Hedgehog Proteins
  • Itraconazole
  • Medulloblastoma
  • Oxides
  • Signal Transduction


  • Recognition of the multiple roles of Hedgehog signaling in cancer has prompted intensive efforts to develop targeted pathway inhibitors. Leading inhibitors in clinical development act by binding to a common site within Smoothened, a critical pathway component. Acquired Smoothened mutations, including SMO(D477G), confer resistance to these inhibitors. Here, we report that itraconazole and arsenic trioxide, two agents in clinical use that inhibit Hedgehog signaling by mechanisms distinct from that of current Smoothened antagonists, retain inhibitory activity in vitro in the context of all reported resistance-conferring Smoothened mutants and GLI2 overexpression. Itraconazole and arsenic trioxide, alone or in combination, inhibit the growth of medulloblastoma and basal cell carcinoma in vivo, and prolong survival of mice with intracranial drug-resistant SMO(D477G) medulloblastoma.

publication date

  • January 14, 2013



  • Academic Article



  • eng

PubMed Central ID

  • PMC3548977

Digital Object Identifier (DOI)

  • 10.1016/j.ccr.2012.11.017

PubMed ID

  • 23291299

Additional Document Info

start page

  • 23

end page

  • 34


  • 23


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