Merkel Cell Polyomavirus Serum Antibody Test May Facilitate Enhanced Risk Stratification

By: Julia Cipriano, MS
Posted: Monday, August 5, 2024

The presence of circulating antibodies to Merkel cell polyomavirus oncoproteins, as indicated by the Merkel cell polyomavirus serum antibody (AMERK) test, appeared to be associated with improved survival outcomes in patients who presented with localized disease, according to David M. Miller, MD, PhD, of Harvard Medical School, Boston, and colleagues. Their findings from a dual-institution retrospective cohort study, which were published in preprint by The Miller Lab and subsequently in the journal Cancer, may facilitate enhanced risk stratification.   

“This improved stratification has the potential to be incorporated into future clinical trials, particularly in identifying a subset of high-risk patients who might benefit most from tailored perioperative therapeutic interventions,” the investigators commented. “By distinguishing patients based on their risk profiles more accurately, the AMERK test could play an important role in refining and personalizing treatment approaches for Merkel cell carcinoma.”

The investigators identified 261 patients who underwent the AMERK test within 90 days of diagnosis. Of this population, 49.4% had an initial seropositive result (titer ≥ 75). A multivariable regression analysis revealed that seropositivity was associated with improved recurrence-free (subdistribution hazard ratio [HR] = 0.48), event-free (HR = 0.58), overall (HR = 0.62), and Merkel cell carcinoma–specific (subdistribution HR = 0.63) survival. The investigators reported strong correlations between the initial AMERK titer and various indicators of tumor burden, including clinical stage (P < .0001), tumor stage (P < .0001), tumor size (P < .0001), nodal stage (P < .0001), and disease extent (P < .0001). Based on a stratified analysis by clinical stage, seropositivity was associated with improved survival only in patients who presented with localized disease.

“The major limitations of this study include its retrospective nature and exploratory data analysis,” the investigators concluded. “Despite these limitations, it serves as an important follow-up [to a single-institution study of the AMERK test].”

Disclosure: Dr. Miller reported no conflicts of interest. For full disclosures of the other study authors, visit acsjournals.onlinelibrary.wiley.com.

Cancer

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