No, for these patients, I have found vismodegib or sonidegib works best. Most cannot tolerate the daily dosing for long, and we cycle the medication usually taking it the first 10 days of the month, then off the rest of the month.
Answer from: Medical Oncologist at Community Practice
Yes. I use itraconazole 100 mg daily with sonidegib 200 mg (daily or less frequently, depending on tolerance, but no less than twice a week) in every patient who shows a resistant SMO mutation on an NGS panel.
I test all patients at baseline and at recurrence to determine what treatment to offer.