Merkel cell carcinoma from 2008 to 2012: Reaching a new level of understanding

Muñoz, I. Prieto; Masferrer, José Pardo; Vegas, J. Olivera; Montalvo, Maria Susana Medina; Díaz, Raquel Jover; Casas, Ana

doi:10.1016/j.ctrv.2012.12.009

Cited by 48 publications

(27 citation statements)

References 80 publications

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“…bACkground Merkel cell carcinoma (MCC) is an aggressive skin cancer associated with a high risk of local and distant metastasis and poor survival outcomes in patients with metastatic disease (5-year survival rate with distant metastases of ≈20%). [1][2][3] MCC is associated with clonal integration of the Merkel cell polyomavirus (MCPyV), ultraviolet radiation exposure, immunosuppression, and advanced age. 4 5 MCC is considered a chemosensitive tumor, but responses to chemotherapy in patients with metastatic MCC (mMCC) are seldom durable.…”

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confidence: 99%

Efficacy and safety of avelumab treatment in patients with metastatic Merkel cell carcinoma: experience from a global expanded access program

Walker

Lebbe

Grignani

et al. 2020

J Immunother Cancer

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BackgroundAvelumab, a human anti–programmed death-ligand 1 immunoglobulin G1 monoclonal antibody, showed favorable efficacy and safety in patients with metastatic Merkel cell carcinoma (mMCC) in the phase II JAVELIN Merkel 200 trial, leading to approval in multiple countries. We describe real-world experience with avelumab in patients with mMCC from an expanded access program.MethodsEligible patients had mMCC and progressive disease during or after chemotherapy or were ineligible for chemotherapy or clinical trial participation. Patients received an initial 3-month supply of avelumab (administered as 10 mg/kg intravenously every 2 weeks until progressive disease or unacceptable toxicity); resupply was allowed following complete response, partial response, stable disease, or clinical benefit per physician assessment.ResultsBetween December 15, 2015, and March 4, 2019, 558 of 620 requests from 38 countries were medically approved, and 494 patients received avelumab. Among 240 evaluable patients, the objective response rate was 46.7% (complete response in 22.9%, including 3 of 16 potentially immunocompromised patients), and the disease control rate was 71.2%. The median duration of treatment in evaluable patients with response was 7.9 months (range, 1.0–41.7) overall and 5.2 months (range, 3.0–13.9) in immunocompromised patients. No new safety signals were identified. The expanded access program closed for new requests on December 31, 2018, as required after regulatory approval; benefitting patients continued to receive avelumab.ConclusionsThe avelumab expanded access program for patients with mMCC demonstrated efficacy and safety in a real-world setting, consistent with the results from JAVELIN Merkel 200, and provided a treatment for patients with limited options.

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confidence: 99%

Efficacy and safety of avelumab treatment in patients with metastatic Merkel cell carcinoma: experience from a global expanded access program

Walker

Lebbe

Grignani

et al. 2020

J Immunother Cancer

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“…Its origin is believed to be the primitive epidermal stem cells capable of epithelial or neuroendocrine differentiation [2]. This tumor is aggressive with high mortality and poor prognosis.…”

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confidence: 99%

“…However, the clinical course of MCC can be more aggressive in males, elderly patients, large tumors, and immunocompromised individuals [3, 4]. One of the most important prognostic factors in clinically node negative (cN0) MCC patients is the presence of occult regional lymph nodal involvement [2, 4–6]. …”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Sentinel Lymph Node Mapping in Merkel Cell Carcinoma: Systematic Review and Meta-Analysis of Prognostic Studies

Sadeghi

Adinehpoor

Maleki

et al. 2014

BioMed Research International

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Aim. To assess through a systematic review and meta-analysis of the literature the prognostic implication of sentinel lymph node mapping in Merkel cell carcinoma (MCC). Materials and Methods. PubMed and SCOPUS databases were searched by using “Merkel AND sentinel” as keywords. All studies with prognostic information regarding SLN mapping in cN0 MCC patients were included. Hazard ratio (HR) for overall survival (OS) and disease free survival (DFS) was used as effect size. Results. SLN biopsy predicted better DFS and OS as compared to the nodal observation in cN0 MCC patients (pooled HR for DFS: 1.61 (95% CI: 1.05–2.46), P = 0.028; pooled HR for OS: 1.08 (95% CI: 0.55–2.10), P = 0.8). Pathologically negative SLN (SLN−) patients had better OS (pooled HR: 4.42 (95% CI: 1.82–10.7), P = 0.0009) and DFS (pooled HR: 2.58 (95% CI: 1.78–3.73)) as compared to SLN+ patients. Conclusion. SLN mapping can provide strong prognostic information regarding OS and DFS in cN0 MCC patients. More importantly, SLN mapping can improve DFS and possibly OS in cN0 MCC patients as compared to nodal observation. As MCC is a rare tumor, large multicenter prospective studies are still needed to validate the survival benefit of SLN mapping.

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“…2,5,8 Immunosuppression, which occurs when the body's normal immune responses are inhibited due to medical intervention or disease, is another recognized risk factor, 2,5 which is suggestive of a viral cause. 8 The discovery of a polyomavirus (MCPyV) 9 in most MCC tumors has offered new insights into its pathogenesis, 8,10,11 although much remains unknown. For example, while there is an established association between MCC and UV irradiation, 8 it is not clear whether UV irradiation contributes directly to the development of MCC or if it acts in combination with immunosuppression.…”

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confidence: 99%

Incidence and Survival for Merkel Cell Carcinoma in Queensland, Australia, 1993-2010

et al. 2014

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Merkel cell carcinoma from 2008 to 2012: Reaching a new level of understanding

Cited by 48 publications

References 80 publications

Efficacy and safety of avelumab treatment in patients with metastatic Merkel cell carcinoma: experience from a global expanded access program

Efficacy and safety of avelumab treatment in patients with metastatic Merkel cell carcinoma: experience from a global expanded access program

Prognostic Significance of Sentinel Lymph Node Mapping in Merkel Cell Carcinoma: Systematic Review and Meta-Analysis of Prognostic Studies

Incidence and Survival for Merkel Cell Carcinoma in Queensland, Australia, 1993-2010

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