Use of Avelumab for Oligoprogression in Advanced Merkel Cell Carcinoma: Case Report
Posted: Monday, August 9, 2021
The aggressive cutaneous neuroendocrine neoplasia Merkel cell carcinoma is associated with early metastasis and a low rate of survival, according to a case report published in the World Journal of Clinical Cases. To the authors’ knowledge, this report highlights the first case of advanced Merkel cell carcinoma with oligoprogression that was managed with avelumab and local radical treatment, explained Telma Costa, MD, of the Centro Hospitalar Vila Nova de Gaia, Portugal, and colleagues. The treatment approach included surgery, radiotherapy, and local radical treatment—while maintaining systemic therapy with avelumab.
The patient was a 61-year-old man who presented with a sporadic fever and an exudative malodorous 10-cm mass on the right gluteal region. He was diagnosed with Merkel cell carcinoma with invasion of adjacent muscle, in-transit metastasis, and bone lesions. After six cycles of cisplatin and etoposide, the main tumor increased in size, indicating disease progression.
Second line treatment with avelumab was initiated 2 months later. The lesion decreased in size after two cycles; however, local disease progression was documented after 16 cycles. Salvage surgery was performed when the tumor became resectable, and systemic treatment with avelumab was continued. Immunotherapy was suspended after the patient developed bilateral pneumonia. More than 2.5 years after surgery—without systemic immunotherapy for the past 19 months—the patient maintained complete local response and stable bone lesions.
“Considering the heterogeneity of these tumors, with different location and distinct degrees of disease progression, the real potential of avelumab is yet to be known,” concluded the authors.
Disclosure: For full disclosures of the study authors, visit www.wjgnet.com.