Merkel Cell Carcinoma: 30-Year Experience from a Single Institution

Santamaria-Barria, Juan A.; Boland, Genevieve M.; Yeap, Beow Y.; Nardi, Valentina; Dias‐Santagata, Dora; Cusack, James C.

doi:10.1245/s10434-012-2779-3

Cited by 121 publications

(107 citation statements)

References 55 publications

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“…Although virtually all patients are initially rendered free of detectable disease, roughly half of these patients will recur [95,96]. Once distant metastatic disease arises, cytotoxic chemotherapy leads to a response in >50% of cases, but the median time to progression is only 3 months and durable responses are exceedingly rare [97].…”

Section: Treatment Of MCCmentioning

confidence: 99%

Rationale for immune-based therapies in Merkel polyomavirus-positive and -negative Merkel cell carcinomas

Vandeven

Nghiem

2016

Immunotherapy

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Merkel cell carcinoma (MCC) is a rare but often deadly skin cancer that is typically caused by the Merkel cell polyomavirus (MCPyV). Polyomavirus T-antigen oncoproteins are persistently expressed in virus-positive MCCs (∼80% of cases), while remarkably high numbers of tumor-associated neoantigens are detected in virusnegative MCCs, suggesting that both MCC subsets may be immunogenic. Here we review mechanisms by which these immunogenic tumors evade multiple levels of host immunity. Additionally, we summarize the exciting potential of diverse immunebased approaches to treat MCC. In particular, agents blocking the PD-1 axis have yielded strikingly high response rates in MCC as compared with other solid tumors, highlighting the potential for immune-mediated treatment of this disease.

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Section: Treatment Of MCCmentioning

confidence: 99%

Rationale for immune-based therapies in Merkel polyomavirus-positive and -negative Merkel cell carcinomas

Vandeven

Nghiem

2016

Immunotherapy

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“…These tumors grow rapidly and tend to metastasize early and frequently to local regions of the body, leading to a relatively poor prognosis with this aggressive disease [2,3,5]. Among patients diagnosed with local or regional disease, the reported rates of recurrence range from 43 to 48% [6,7]. The 5-year overall survival (OS) rate is 40% [1] and the mortality rate with MCC is greater than that with other skin cancers, including melanoma [4].…”

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confidence: 99%

Real-world treatment outcomes in patients with metastatic Merkel cell carcinoma treated with chemotherapy in the USA

et al. 2017

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aim: This retrospective study of patients in the USA with metastatic Merkel cell carcinoma (mMCC) aimed to assess patient responses to second-line and later (2L+) and first-line (1L) chemotherapy. Patients & methods: Out of 686 patients with MCC identified in The US Oncology Network, 20 and 67 patients with mMCC qualified for the 2L+ and 1L study, respectively; the primary analysis population was restricted to immunocompetent patients. Results: In the 2L+ primary analysis population, objective response rate (ORR) was 28.6%, median duration of response (DOR) was 1.7 months and median progression-free survival was 2.2 months. In the 1L primary analysis population, ORR was 29.4%, median DOR was 6.7 months and median progression-free survival was 4.6 months. conclusion: The low ORR and brief DOR underscore the need for novel therapies. Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer that occurs most frequently in elderly and immunocompromised patients [1][2][3]. There are approximately 1500 cases of MCC per year in the USA, and the incidence has dramatically increased over the last 20 years [4]. MCC typically presents as painless growths that are clinically unremarkable in appearance and are usually found on sun-exposed areas, such as the head and neck [2,3]. These tumors grow rapidly and tend to metastasize early and frequently to local regions of the body, leading to a relatively poor prognosis with this aggressive disease [2,3,5]. Among patients diagnosed with local or regional disease, the reported rates of recurrence range from 43 to 48% [6,7]. The 5-year overall survival (OS) rate is 40% [1] and the mortality rate with MCC is greater than that with other skin cancers, including melanoma [4].Recently, avelumab, a human IgG1 anti-programmed death-ligand 1 (PD-L1) monoclonal antibody, was approved by the US FDA as the first and only approved treatment for patients with metastatic MCC (mMCC) [8]. Before this approval, there was no evidence-based standard therapeutic regimen for mMCC. The National Comprehensive Cancer Network treatment guidelines for mMCC [9] are based on those used for small cell lung cancer, as both are aggressive and poorly differentiated cancers [10]. Treatments typically include platinum agents, such as carboplatin or cisplatin with or without etoposide or topotecan, and are associated with high toxicity [9,11]. Although MCC is generally considered a chemosensitive tumor, responses to chemotherapy in metastatic disease are For reprint orders, please contact: reprints@futuremedicine.com

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“…However, the data on the prognostic implication of SLNB in MCC are mixed, and it is unclear if it carries the same prognostic guidance as it does for melanoma [64]. A report from Memorial Sloan Kettering found that SLN-positive patients received more adjuvant therapy, however, their 2-year recurrence and survival rates were not significantly different (12 vs 12%; p = 0.86 and 6.1 vs 5.7%; p = 0.89) [65].…”

Section: Merkel Cell Carcinomamentioning

confidence: 99%

Sentinel lymph node biopsy for cutaneous head and neck malignancies

Dwojak

Emerick

2014

Expert Review of Anticancer Therapy

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Sentinel lymph node biopsy (SLNB) is a procedure that can provide critical information regarding pathologic lymph node status and accurate regional staging. This is very important for developing treatment plans and providing prognostic guidance for cutaneous malignancies. The head and neck (HN) region is unique from other body sites due to its complex lymphatic drainage pathways, multiple lymph node basins, proximity of important cranial nerves and potential for contralateral or bilateral drainage. These unique aspects of the HN previously created some uncertainty about the use of SLNB in the HN. This review will discuss the current reliable status of HN SLNB and provide a guide for its current application in cutaneous malignancy of the HN.

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Merkel Cell Carcinoma: 30-Year Experience from a Single Institution

Cited by 121 publications

References 55 publications

Rationale for immune-based therapies in Merkel polyomavirus-positive and -negative Merkel cell carcinomas

Rationale for immune-based therapies in Merkel polyomavirus-positive and -negative Merkel cell carcinomas

Real-world treatment outcomes in patients with metastatic Merkel cell carcinoma treated with chemotherapy in the USA

Sentinel lymph node biopsy for cutaneous head and neck malignancies

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