Response to Anti-PD-1 Therapy in Metastatic Merkel Cell Carcinoma Metastatic to the Heart and Pancreas

Curēus
Kalyan Mantripragada, Ariel Birnbaum

Abstract

Metastatic Merkel cell carcinoma (MCC) is a lethal, Merkel cell polyomavirus (MCPyV) cancer with no currently available effective therapy. Harnessing the immune system through an immune checkpoint blockade is an attractive option because the immune system appears to be dysfunctional in the Merkel cell tumor microenvironment. Although MCPyV is expressed in 80% of MCCs and serves as a powerful antigen for stimulating host immune response, intratumoral CD8+ T-cell infiltration is seen only in 18% of MCCs. In contrast, about 50% of MCPyV-positive MCCs express the programmed death-ligand 1 (PD-L1) on multiple cell types in the tumor microenvironment. We present a case of a young patient with MCC involving the heart and pancreas that showed an impressive response after treatment with four cycles of the anti-PD-1 monoclonal antibody, nivolumab.

Citations

Apr 21, 2009·The Journal of Surgical Research·Alex D SweeneyWilliam E Fisher
Dec 1, 2017·Journal of Clinical Medicine·Uyen Ngoc MuiStephen K Tyring
Mar 2, 2019·Dermatology and Therapy·Alessia VillaniMassimiliano Scalvenzi
Jun 29, 2018·International Journal of Molecular Sciences·Aelita KonstatinellUgo Moens

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Methods Mentioned

BETA
biopsy
dissection

Clinical Trials Mentioned

NCT02488759

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