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Soo Park, MD
Soo Park, MD
Posted: Tuesday, February 18, 2025
Although the incidence of Merkel cell carcinoma has been rising worldwide, the use of PD-L1 inhibitors has been an effective treatment option in patients with advanced disease. Ines Pires da Silva, MD, FRACP, PhD, of Melanoma Institute Australia, Wollstonecraft, Australia, and colleagues evaluated the patterns of disease progression and response of advanced melanoma to anti–PD-L1 therapies to determine management strategies. The results of this study were published in the European Journal of Cancer. Jeremy Mo, MD, of Westmead Hospital, Australia, is the first author of the study.
“The most common subsequent treatment for patients with primary resistance was chemotherapy, [whereas] those with secondary resistance most frequently underwent further anti–PD-L1 therapy in combination with other therapies,” the investigators concluded. “Despite both therapies demonstrating promising objective response rates, doublet platinum chemotherapy had a poorer duration of response compared to anti–PD-L1 rechallenge.”
This international, multicenter study retrospectively reviewed the data of 185 patients with advanced Merkel cell carcinoma who underwent at least one cycle of anti–PD-L1 therapy. Study endpoints included progression-free survival, overall survival, objective response rate, and duration of response.
The median follow-up was 28.7 months, and most patients received anti–PD-L1 therapy (n = 144); 41 of them received anti–PD-1 therapy. At follow-up, the objective response rate was 57.3%, and the median duration of response was 42.8 months. The median overall survival and progression-free survival were 42.8 and 14 months, respectively. Disease progression was reported in 58% of patients, with 50% exhibiting primary resistance, and 26% experiencing secondary resistance.
Approximately 56% of patients underwent subsequent systemic therapy; 29% had systemic therapy alone, and 27% had systemic therapy with local treatment. Available response data revealed that 36% of these patients received doublet platinum chemotherapy, with an objective response rate of 67% and a median duration of response of 5 months. Of the 16 patients rechallenged with anti–PD-L1 therapy, the objective response rate and the median duration of response were 56% and 20.2 months, respectively.
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
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