A Therapeutic and Diagnostic Multidisciplinary Pathway for Merkel Cell Carcinoma Patients

Rastrelli, Marco; Fiore, Paolo Del; Buja, Alessandra; Vecchiato, Antonella; Rossi, Carlo Riccardo; Sileni, V. Chiarion; Tropea, Saveria; Russano, Francesco; Zorzi, Manuel; Spina, Romina; Cappellesso, Rocco; Mazzarotto, Renzo; Cavallin, Francesco; Bassetto, Franco; Bezzon, Elisabetta; Ferrazzi, Beatrice; Alaibac, Mauro; Mocellin, Simone

doi:10.3389/fonc.2020.00529

Cited by 9 publications

(11 citation statements)

References 40 publications

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“…To sum up and take into consideration the absence of a coded algorithm, the therapeutic approach of each case of MCC should be discussed by a multidisciplinary group consisting of at least an oncologist, a dermatologist, a surgeon, and a radiotherapist ( 67 , 68 ).…”

Section: Treatment Of Primary Tumormentioning

confidence: 99%

Merkel Cell Carcinoma: An Immunotherapy Fairy-Tale?

et al. 2021

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Merkel cell carcinoma (MCC) is a rare, highly aggressive, neuroendocrine cutaneous tumor. The incidence of MCC is growing worldwide, and the disease-related mortality is about three-fold higher than melanoma. Since a few years ago, very little has been known about this disease, and chemotherapy has been the standard of care. Nowadays, new discoveries about the pathophysiology of this neoplasm and the introduction of immunotherapy allowed to completely rewrite the history of these patients. In this review, we provide a summary of the most important changes in the management of Merkel cell carcinoma, with a focus on immunotherapy and a landscape of future treatment strategies.

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Section: Treatment Of Primary Tumormentioning

confidence: 99%

Merkel Cell Carcinoma: An Immunotherapy Fairy-Tale?

et al. 2021

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“…Merkel cell carcinoma (MCC) is a rare and highly aggressive malignancy of the skin (1)(2)(3)(4). MCC usually presents itself as a rapidly growing pink to red-violet indurated plaque or nodule on sun-damaged skin, most commonly on the head and neck and less frequently on the trunk and extremities (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…MCC is characterized by a high rate of local recurrence and nodal metastasis, a high mortality rate, and a deep psychological impact (12). The treatment regimen depends on the stage of the disease and includes surgery, radiation, chemotherapy, and/or immunotherapy (4,7,13). Surgical treatment consists of a wide excision of the primary lesion, sentinel lymph node biopsy, and/ or regional lymph node dissection.…”

Section: Introductionmentioning

confidence: 99%

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Merkel Cell Carcinoma: Evaluation of the Clinico-Pathological Characteristics, Treatment Strategies and Prognostic Factors in a Monocentric Retrospective Series (n=143)

et al. 2021

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BackgroundMerkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin. The incidence of the disease has undergone a significant increase in recent years, which is caused by an increase in the average age of the population and in the use of immunosuppressive therapies. MCC is an aggressive pathology, which metastasizes early to the lymph nodes. These characteristics impose an accurate diagnostic analysis of the regional lymph node district with radiography, clinical examination and sentinel node biopsy. In recent years, there has been a breakthrough in the treatment of the advanced pathology thanks to the introduction of monoclonal antibodies acting on the PD-1/PD-L1 axis. This study aimed to describe the clinico-pathological characteristics, treatment strategies and prognostic factors of MCC.MethodsA retrospective cohort study was conducted involving 143 consecutive patients who were diagnosed and/or treated for MCC. These patients were referred to the Veneto Institute of Oncology IOV-IRCCS and to the University Hospital of Padua (a third-level center) in the period between December 1991 and January 2020. In the majority of cases, diagnosis took place at the IOV. However, some patients were diagnosed elsewhere and subsequently referred to the IOV for a review of the diagnosis or to begin specific therapeutic regimens.Results143 patients, with an average age of 71 years, were affected mainly with autoimmune and neoplastic comorbidities. Our analysis has shown that age, autoimmune comorbidities and the use of therapy with immunomodulating drugs (which include corticosteroids, statins and beta-blockers) are associated with a negative prognosis. In this sense, male sex is also a negative prognostic factor.ConclusionsAutoimmune and neoplastic comorbidities were frequent in the studied population. The use of drugs with immunomodulatory effects was also found to be a common feature of the population under examination. The use of this type of medication is considered a negative prognostic factor. The relevance of a multidisciplinary approach to the patient with MCC is confirmed, with the aim of assessing the risks and benefits related to the use of immunomodulating therapy in the individual patient.

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“…2 As expert opinion, an Italian group has suggested brain MRI in all cases of T2 to T4 tumors and in T1 tumors with suspected brain involvement. 3 A recent study focusing on the yield of nonbrain staging imaging in MCC revealed that 13.2% of patients with clinically node-negative disease and 10.8% of patients with clinically node-positive disease were upstaged.…”

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confidence: 99%