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Metastatic Merkel Cell

Young Lee, Phillip Chao, Christin Coomarasamy, Jon A Mathy
BACKGROUND/OBJECTIVES: Merkel cell carcinoma is an aggressive neuroendocrine skin cancer. Australian studies report high incidence and poor survival rates compared internationally. While New Zealand has a comparable UV index and racial composition to Australia, survival outcomes are currently unknown. The role of Merkel cell polyoma virus in oncogenesis of Merkel cell carcinoma is an active area of research. We describe the incidence and survival of Merkel cell carcinoma in New Zealand with correlation to demographic and clinical factors including regional polyoma virus prevalence...
March 21, 2019: Australasian Journal of Dermatology
Monica K Rossi, D Anand Rajan Kanagasabapathy, Henry T Hoffman
Merkel cell carcinoma (MCC) is a neuroendocrine cutaneous malignancy that may present as metastatic disease without a known primary site but, most commonly originates in the sun-exposed skin of the head, neck, and extremities. We present a 66-year-old male treated with chemo-radiation for T3N2cM0 laryngeal squamous cell carcinoma (SCCa) six years before he was diagnosed with MCC isolated to the radiated laryngopharynx. Mucosal MCC is rare and radiation-induced MCC has been hypothesized to occur in previously radiated tissue but, never before to the laryngopharynx...
March 9, 2019: American Journal of Otolaryngology
Victoria S North, Larissa Habib, Michael K Yoon
Merkel cell carcinoma (MCC) is a rare, aggressive tumor of both epithelial and neuroendocrine origin that carries a mortality rate of up to 40%. MCC tumors typically present as painless, expanding nodules on the sun-exposed skin areas of older, white patients. Eyelid and periocular tumors comprise approximately 2.5% of all cases of MCC and may be mistaken for chalazia or basal cell carcinomas. Immunosuppression is a significant risk factor, particularly in solid-organ transplant recipients, patients with chronic lymphocytic leukemia, and patients with HIV...
March 11, 2019: Survey of Ophthalmology
Na Li, Guodong Wang, Xiaohong Jiang, Minguang Huang, Huanyong Tian, Feng Xuan, Yufeng Zhang, Yanting Lv, Mengjun Hu, Zhen Wang, Peng Ren, Maoyi Xu
Merkel cell carcinoma (MCC) is a rare, aggressive skin malignancy that has a propensity for local recurrence and metastasis to the lymph nodes. In this case report, we discuss a 54-year-old female with rheumatoid arthritis (RA) who had received treatment with prednisone (15 mg/day) for symptom relief and management. The patient visited our hospital with complaints of a nodule in right preauricular area. Computed tomography (CT) scans revealed no distant metastasis. The patient underwent surgical resection and histopathological evaluation of the nodule led to the diagnosis of MCC...
2019: OncoTargets and Therapy
Alessia Villani, Gabriella Fabbrocini, Claudia Costa, Maria Carmela Annunziata, Massimiliano Scalvenzi
Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine skin cancer whose incidence has almost doubled in recent decades. Risk factors for MCC include age > 65 years, immunosuppression, sun exposure and infection by Merkel cell polyomavirus. MCC usually presents as rapidly growing, firm, red to violaceous nodule localized on the sun-exposed skin. Surgery followed by radiation therapy is considered to be the first-line treatment for primary or loco-regional MCC in order to prevent recurrences and lymph node metastasis, while chemotherapy has always been used to treat advanced forms...
February 28, 2019: Dermatology and Therapy
Phyu P Aung, Edwin R Parra, Souptik Barua, Dawen Sui, Jing Ning, Barbara Mino, Debora A Ledesma, Jonathan L Curry, Priyadharsini Nagarajan, Carlos A Torres Cabala, Eleni Efstathiou, Anh Hoang, Michael K K Wong, Jennifer A Wargo, Alexander J Lazar, Arvind Rao, Victor G Prieto, Ignacio I Wistuba, Michael T Tetzlaff
PURPOSE: Merkel cell carcinoma is an aggressive cutaneous malignancy whose pathogenesis and prognosis are related to the integrity of the host immune system. Despite promising clinical responses to immune checkpoint blockade, response and resistance remain unpredictable, underscoring a critical need to delineate novel prognostic biomarkers and/or therapeutic targets for this disease. EXPERIMENTAL DESIGN: Expression of immune regulatory markers (PD-L2, B7-H3, B7-H4, IDO-1, ICOS, TIM3, LAG3, VISTA and OX-40) was assessed using singlet chromogenic immunohistochemistry in 10 primary MCCs...
February 26, 2019: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Mahtab Samimi
Merkel cell carcinoma (MCC) is an aggressive skin cancer. Until 2017, patients with advanced disease were typically treated with conventional chemotherapies, with a median response duration of 3 months. Increased evidence of the role of the immune system in controlling this cancer has paved the way for immune-based therapies, with programmed cell death protein 1 (PD-1)/programmed cell death protein ligand 1 (PD-L1) inhibitors at the frontline. Avelumab, an anti-PD-L1 antibody, was the first-ever drug approved in advanced MCC after showing meaningful efficacy in a second-line setting...
February 19, 2019: American Journal of Clinical Dermatology
Margaret Ottaviano, Sabino De Placido, Paolo Antonio Ascierto
AbstractSeveral researches have been carried over the last few decades to understand of how cancer evades the immune system and thus to identify therapies that could directly act on patient's immune system in the way of restore or induce a response to cancer. As a consequence, "cancer immunotherapy" is conquering predominantly the modern scenario of the fight against cancer. The recent clinical success of immune checkpoint inhibitors (ICIs) has created an entire new class of anti-cancer drugs and restored interest in the field of immuno-oncology, leading to regulatory approvals of several agents for the treatment of a variety of malignancies...
February 12, 2019: Virchows Archiv: An International Journal of Pathology
Yui Shibayama, Hiraku Kameda, Shoichiro Ota, Kazuhisa Tsuchida, Kyu Yong Cho, Akinobu Nakamura, Hideaki Miyoshi, Tatsuya Atsumi
With the expansive use of immune checkpoint inhibitors (ICIs), the frequency of immune-related adverse events, including autoimmune type 1 diabetes, have been exponentially increased. The anti-programmed death-ligand 1 antibody, avelumab, has recently been approved for metastatic Merkel cell carcinoma (MCC) therapy. Herein, we report a patient that developed fulminant type 1 diabetes during avelumab treatment. An 81-year-old woman with no history of diabetes received avelumab for metastatic MCC. Elevated plasma glucose level (483 mg/dL), hemoglobin A1c level (7...
February 9, 2019: Journal of Diabetes Investigation
Sandra P D'Angelo, Matthias Hunger, Andrew S Brohl, Paul Nghiem, Shailender Bhatia, Omid Hamid, Janice M Mehnert, Patrick Terheyden, Kent C Shih, Isaac Brownell, Céleste Lebbé, Karl D Lewis, Gerald P Linette, Michele Milella, Michael Schlichting, Meliessa H Hennessy, Murtuza Bharmal
BACKGROUND: Response rates are primary endpoints in many oncology trials; however, correlation with overall survival (OS) is not uniform across cancer types, treatments, or lines of therapy. This study explored the association between objective response (OR) and OS in patients with chemotherapy-refractory metastatic Merkel cell carcinoma who received avelumab (anti-PD-L1). METHODS: Eighty-eight patients enrolled in JAVELIN Merkel 200 (part A; NCT02155647) received i...
February 5, 2019: Cancer Immunology, Immunotherapy: CII
Véronique Del Marmol, Celeste Lebbé
PURPOSE OF REVIEW: Merkel cell carcinoma (MCC), a rapidly progressing skin cancer, has poor prognosis. We reviewed the epidemiology, pathogenesis, diagnosis and treatment of MCC, with a focus on recent therapeutic advancements. RECENT FINDINGS: Risk factors for MCC, such as old age, immunosuppression, polyomavirus infection and exposure to UV radiation have already been identified, but the underlying mechanisms leading to carcinogenesis still need clarification...
March 2019: Current Opinion in Oncology
Ariel S Berkowitz, Tzahi Neuman, Shahar Frenkel, Ron Eliashar, Jeffrey M Weinberger, Nir Hirshoren
No abstract text is available yet for this article.
January 2019: Israel Medical Association Journal: IMAJ
Heather Ugolini, Jennifer Bryan, Meliessa Hennessy, Howard L Kaufman, Sandra D'Angelo
BACKGROUND: Metastatic Merkel cell carcinoma (mMCC) is a rare skin cancer with poor prognosis. Avelumab is the first approved treatment option for patients with mMCC. Immune checkpoint inhibitors, such as avelumab, are associated with unique toxicities that can be effectively addressed with prompt recognition and appropriate management. OBJECTIVES: This article discusses the use of avelumab for the treatment of mMCC and management of associated toxicities. METHODS: Literature on mMCC disease state and clinical trial data for avelumab were reviewed...
February 1, 2019: Clinical Journal of Oncology Nursing
Ash Bullement, Paul Nathan, Anna Willis, Amerah Amin, Cameron Lilley, Ceilidh Stapelkamp, Anthony Hatswell, Chris Pescott, Murtuza Bharmal
BACKGROUND: Metastatic Merkel cell carcinoma (mMCC) is a rare and aggressive skin cancer. Until recently, there were no licensed treatment options for patients with mMCC, and prognosis was poor. A cost-effectiveness analysis was conducted for avelumab, a newly available treatment option for mMCC, versus standard care (SC), from a UK National Health Service perspective. METHODS: A partitioned survival model was developed to assess the lifetime costs and effects of avelumab versus SC...
January 24, 2019: PharmacoEconomics Open
Annett Linge, Ricarda Rauschenberg, Sophia Blum, Petra Spornraft-Ragaller, Friedegund Meier, Esther G C Troost
This case report presents a HIV-positive 60-year old male with Merkel cell carcinoma of his right forearm and pulmonary sarcoidosis, who, after excisions and irradiations of the primary tumour site and subsequent lymph node metastases developed distant metastases. He received radiotherapy to symptomatic mediastinal lymph node metastases followed by Doxorubicin and, after two cycles, by the PD-1 inhibitor Pembrolizumab due to mixed response. Re-staging showed a para-mediastinal, radiotherapy-induced pneumonitis, which was treated by prednisolone due to clinical symptoms...
February 2019: Clinical and Translational Radiation Oncology
Pauline Tétu, Barouyr Baroudjian, Isabelle Madelaine, Julie Delyon, Céleste Lebbé
Merkel Cell Carcinoma (MCC) is a rare neuroendocrine skin cancer that is associated with frequent recurrences and a high mortality rate. In the recent past years, incidence rates of MCC have increased in the USA, Australia and Europe. About one third of patients present metastatic disease at the time of diagnosis or will develop metastases in the course of their disease. Although advanced MCC is chemosensitive, responses to cytotoxic chemotherapy are mostly of short duration and toxicity is potentially high...
December 19, 2018: Bulletin du Cancer
S A Zafar, O M Ahmed, M R Boland, N Aucharaz, A Lal
Introduction Merkel cell carcinoma (MCC) is a rare cutaneous tumour that is clinically aggressive with a high local, regional, and distant metastatic potential. Cases Three male patients presented to University Hospital Limerick (UHL) in 2015 with cutaneous lesions of the thorax, buttock and forearm. Once MCC was confirmed, management included surgical wide local excision (WLE) with regional lymph node dissection followed by adjuvant radiotherapy. One patient is in remission. The second has residual locoregional lymph node disease and is undergoing annual CT surveillance...
October 11, 2018: Irish Medical Journal
Ajay Prakash, Alhossain A Khalafallah
Hairy cell leukemia (HCL) and Merkel cell carcinoma (MCC) are two rare malignancies with distinct cells of origin. HCL is a lymphoid malignancy of mature B cells, and MCC derives from neuroendocrine cell origin. HCL has a favorable prognosis with most patients achieving long-term remission and potential cure. In contrast, MCC is an aggressive malignancy affecting the skin and can metastasize quickly with a dismal prognosis. Immunocompromised patients, such as those with AIDS, posttransplant, and the elderly, have higher incidences than the general population, suggesting a possible immune mechanism...
2018: Case Reports in Oncological Medicine
Robert H Goldstein, James A DeCaprio
Merkel cell carcinoma (MCC) is a highly aggressive, primary neuroendocrine cancer of the skin. The majority of MCC cases are associated with the recently discovered Merkel cell polyomavirus (MCPyV), while the remaining are caused by ultraviolet (UV) light-induced mutations from excessive sunlight exposure. The risk of developing MCC is much higher in the white population relative to all other races. Approximately 10% of all patients with MCC have some form of immunosuppression including HIV-1/AIDS, chronic inflammatory conditions, solid organ transplantation, or hematological malignancies...
2019: Cancer Treatment and Research
Julie M Collins, James L Gulley
Although immunotherapies have been employed for many decades, immune checkpoint inhibitors have only recently entered the oncologic landscape. Avelumab is a fully human monoclonal antibody that blocks the interaction between PD-L1 on tumor cells and PD-1 on T cells, thereby inhibiting immunosuppression in the tumor microenvironment and reducing tumor growth. Most early clinical trials of avelumab as monotherapy and in combination regimens were part of the international JAVELIN clinical trial program, which included more than 7000 patients in more than 30 trials with at least 15 tumor types...
November 27, 2018: Human Vaccines & Immunotherapeutics
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