Non-Melanoma Skin Cancers Coverage from Every Angle

Potential Biomarker Investigated for Merkel Cell Carcinoma

By: Celeste L. Dixon
Posted: Tuesday, September 29, 2020

Currently, no adequate biomarker for Merkel cell carcinoma exists, but a potential candidate has been revealed in the Annals of Surgical Oncology. The value of serum neuron-specific enolase (NSE) is that it “correlates with [the] extent of disease, … [can] rule out progression, and distinguishes responders from nonresponders during immunotherapy,” wrote Alexander C.J. van Akkooi, MD, PhD, of Netherlands Cancer Institute, Amsterdam, and colleagues.

Found in neuronal and neuroendocrine tissues, the enzyme is commonly used as a biomarker for several other small cell malignancies, including small cell lung carcinoma and neuroblastoma, they noted. This was reportedly the largest study to date to evaluate NSE serum levels in a prospective cohort of patients with Merkel cell carcinoma (n = 84; 565 serum samples).

The authors performed a separate evaluation for the subgroup treated with immunotherapy (n = 23). The median level of the NSE samples was 15 ng/mL. Although baseline levels of the compound had no association with prognosis, reported Dr. van Akkooi and co-investigators, serum NSE levels “correlated with [the] extent of disease (P = .01) and increased with 15 ng/mL/class (no tumor load, localized Merkel cell carcinoma, regional or distant metastases, respectively).”

The association was particularly clear in the patients receiving immunotherapy. All 10 patients who were complete responders had normalized NSE values of up to 18.2 ng/mL, and the 5 partial responders had decreased NSE values. However, the levels of the enzyme remained elevated in all eight nonresponders. 

Disclosure: The study authors’ disclosure information can be found at

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