Favorable Response to Treatment with Avelumab in an HIV-Positive Patient with Advanced Merkel Cell Carcinoma Previously Refractory to Chemotherapy

Case Reports in Oncology
Mohammed U Al HomsiKhaled Fahim

Abstract

Avelumab is indicated for the management of Merkel cell carcinoma, a rare and aggressive neuroendocrine skin cancer. Its regulatory approval followed the positive outcome of a Phase 2 trial on 88 patients with stage IV disease, which excluded patients with immunodeficiency due to HIV, a risk factor for this cancer type. We report a positive and sustained response to avelumab in an HIV-positive patient with stage IV Merkel cell carcinoma refractory to previous chemotherapy (cisplatin/etoposide) and radiotherapy. Five cycles of avelumab 10 mg/m2 resulted in the resolution of tumor activity visualized using PET-CT scanning in all affected lymph nodes. The only major side effect associated with avelumab was thyroiditis and mild hypothyroidism, a known adverse effect of this treatment, which was well controlled by L-thyroxine treatment. Treatment is ongoing and the positive response has been sustained during 5 further cycles of treatment up to date. This apparently durable response is consistent with the earlier clinical trial experience with avelumab, but seen here in a patient with HIV-associated immunodeficiency as a predisposing factor (an exclusion criterion from the previous trial). Further clinical trials with avelumab in a b...Continue Reading

References

Dec 17, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Dirk SchadendorfJürgen C Becker
Apr 6, 2017·Journal of Biomedical Science·Yoshiko IwaiTasuku Honjo
May 1, 2017·Drugs·Esther S Kim

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Citations

Jan 9, 2019·Journal of Cancer Research and Clinical Oncology·Marco GalloUNKNOWN NIKE Group
Mar 2, 2019·Dermatology and Therapy·Alessia VillaniMassimiliano Scalvenzi
Jan 29, 2020·The Journal of Immunology : Official Journal of the American Association of Immunologists·Renée M Van der SluisSharon R Lewin
Jan 29, 2022·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Suha Abu KhalafMaria C Rodriguez-Barradas

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Methods Mentioned

BETA
biopsy
hormone replacement therapy

Software Mentioned

JAVELIN

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