Circulating tumor DNA as a predictive biomarker in Merkel cell carcinoma

Park, S.J.; Kannan, Aarthi; Harris, Jeremy P.; Lacy, Curtis; Daniels, Gregory A.; Lee, Steve P.; Lambrecht, Nils; Hook, Nicole; Olshan, Perry; Billings, Paul R.; Aleshin, Alexey; Gao, Ling

doi:10.1016/j.jaad.2022.03.020

Cited by 14 publications

(22 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, ctDNA has yet to be fully validated and incorporated into routine clinical practice for MCC. Several studies suggest that ctDNA levels may be sensitive enough to detect early recurrence in MCC and could potentially be used as a tool to monitor these patients for the longer term ( 26 , 27 ). For example, in this case, ctDNA levels may have been used to follow for recurrence after surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Case report: Metastatic Merkel cell carcinoma presenting seven years after loco-regional disease resection of primary tumor with interval in-transit and nodal metastases

et al. 2023

View full text Add to dashboard Cite

Merkel cell carcinoma (MCC) is a rare tumor with a high risk of recurrence after definitive therapy; however, the optimal duration of surveillance is unclear. First recurrences typically occur within 3 years. National guidelines recommend that patients undergo physical examination and imaging for surveillance during this time period. However, the duration of surveillance beyond this is not defined. Here, we describe a case of a patient developing a recurrence of MCC 7 years after the primary diagnosis with interval in-transit and regional lymph node metastases 15 months following the treatment of the primary MCC. Such late recurrences are rare, largely not reported, and the risk factors contributing to late recurrences are not well described. This case highlights the possibility of late recurrences of MCC after an initial in-transit and nodal recurrence and underscores the importance of identifying predictors of recurrence that may better guide the duration of surveillance.

show abstract

Section: Discussionmentioning

confidence: 99%

Case report: Metastatic Merkel cell carcinoma presenting seven years after loco-regional disease resection of primary tumor with interval in-transit and nodal metastases

et al. 2023

View full text Add to dashboard Cite

show abstract

“…For patients with UV light induced MCC, cell free circulating tumor DNA (ctDNA) may serve as a potential alternative tool for prognostication and treatment response prediction for MCC. Prior studies have demonstrated ctDNA as a predictor of MCC treatment response, 78 as well as a sensitive biomarker of residual disease and relapse after treatment 79 . Further work is necessary to elucidate the prognostic role of ctDNA in MCC management.…”

Section: Discussionmentioning

confidence: 99%

“…One study observed absence of immunosuppression, predominance of central memory CD8 + T cells among TILs, and a limited number of tumor affected organs as markers associated with response to anti‐PD‐(L)1 therapy 90 . Other studies have demonstrated a role for ctDNA as a predictor of response to therapy 79 . In addition, identifying alternative treatments for checkpoint inhibitor refractory patients also remains an active area of research.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have demonstrated ctDNA as a predictor of MCC treatment response, 78 as well as a sensitive biomarker of residual disease and relapse after treatment. 79 Further work is necessary to elucidate the prognostic role of ctDNA in MCC management.…”

Section: Discussionmentioning

confidence: 99%

“… 90 Other studies have demonstrated a role for ctDNA as a predictor of response to therapy. 79 In addition, identifying alternative treatments for checkpoint inhibitor refractory patients also remains an active area of research. As previously mentioned, various therapies such as anti‐MDM2, anti‐HDACi, and combination IPI/NIVO have been explored for anti‐PD‐(L)1 refractory patients.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Best practices in surgical and nonsurgical management of head and neck Merkel cell carcinoma: An update

Duarte-Bateman

Shen

Bullock

et al. 2022

Molecular Carcinogenesis

View full text Add to dashboard Cite

Merkel cell carcinoma (MCC) is a rare, highly aggressive cutaneous neuroendocrine carcinoma. Controversy exists regarding optimal management of MCC as high-quality randomized studies and clinical trials are limited, and physicians are bound to interpret highly heterogeneous, retrospective literature in their clinical practice. Furthermore, the rising incidence and notably poor prognosis of MCC urges the establishment of best practices for optimal management of the primary tumor and its metastases. Herein, we summarized the relevant evidence and provided an algorithm for decision-making in MCC management based on the latest 2021 National Comprehensive Cancer Network guidelines. Additionally, we report current active MCC clinical trials in the United States. The initial management of MCC is dependent upon the pathology of the primary tumor and presence of metastatic disease. Patients with no clinical evidence of regional lymph node involvement generally require sentinel node biopsy (SLNB) while clinically node-positive patients should undergo fine needle aspiration (FNA) or core biopsy and full imaging workup. If SLNB or FNA/core biopsy are positive, a multidisciplinary team should be assembled to discuss if additional node dissection or adjuvant therapy is necessary. Wide local excision is optimal for primary tumor management and SLNB remains the preferred staging and predictive tool in MCC. The management of MCC has progressively improved in the last decade, particularly due to the establishment of immunotherapy as a new treatment option in advanced MCC. Ongoing trials and prospective studies are needed to further establish the best practices for MCC management.

show abstract

Late subsequent Merkel cell carcinoma after 21 years of the first primary diagnosis: When to de‐escalate surveillance?

Borda,

Cushman,

Pariser

2024

Clinical Case Reports

View full text Add to dashboard Cite

Key Clinical MessageMerkel cell carcinoma (MCC) presents challenges in surveillance due to varied recurrence rates and uncertain follow‐up protocols, especially in late recurrent cases. These cases need personalized monitoring strategies beyond traditional timelines, such as clinical and molecular factors, in order to optimize patient outcomes.AbstractMerkel cell carcinoma (MCC) is a rare, aggressive skin cancer with neuroendocrine differentiation with a propensity for recurrence following initial treatment. Surveillance strategies for MCC patients lack specificity, and the duration of surveillance remains uncertain, posing challenges in identifying appropriate follow‐up intervals. Therefore, we present a 94‐year‐old woman, with history of stage IA MCC in her left nasal wall 21 years prior, that presented with a dome‐shaped eroded nodule on her left fifth finger. Biopsy showed characteristic MCC features with positive immunohistochemistry for CD56, synaptophysin, and CK20 (perinuclear dotting). The patient opted against further imaging or lymph node biopsy and underwent Mohs micrographic surgery. To date, there has not been any evidence of recurrence at previous sites or development of new primary lesions. This case underscores the need for ongoing surveillance despite long disease‐free intervals. It also stands out as the case demonstrating the longest latency/recurrence‐free interval following the initial diagnosis of MCC in the literature. While most recurrences occur within the first few years post‐diagnosis, our case highlights the exceptional nature of late recurrences and prompts reevaluation of surveillance protocols. Current guidelines recommend surveillance for up to 3 years post‐treatment, but factors, such as patient demographics and tumor characteristics, may warrant extended monitoring periods. Emerging biomarkers, such as Merkel cell polyomavirus status and circulating tumor DNA, show promise in predicting and monitoring recurrences, but their utility in late recurrence detection requires further investigation.

show abstract

Circulating tumor DNA as a predictive biomarker in Merkel cell carcinoma

Cited by 14 publications

References 5 publications

Case report: Metastatic Merkel cell carcinoma presenting seven years after loco-regional disease resection of primary tumor with interval in-transit and nodal metastases

Case report: Metastatic Merkel cell carcinoma presenting seven years after loco-regional disease resection of primary tumor with interval in-transit and nodal metastases

Best practices in surgical and nonsurgical management of head and neck Merkel cell carcinoma: An update

Late subsequent Merkel cell carcinoma after 21 years of the first primary diagnosis: When to de‐escalate surveillance?

Contact Info

Product

Resources

About