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If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Merkel cell carcinoma MCC is a rare and aggressive neuroendocrine cutaneous malignancy with poor prognosis. In Europe, approved systemic therapies are limited to the PD-L1 inhibitor avelumab.
For avelumab-refractory patients, efficient and safe treatment options are lacking. Five patients treated at three different academic sites in Germany were enrolled. Merkel cell carcinoma MCC is a highly aggressive and rare cutaneous malignancy that is induced by the Merkel cell polyomavirus MCPyV or ultraviolet irradiation [ 1 ]. Until recently, treatment of advanced or metastatic MCC was limited to chemotherapy showing significant but short-lived activity [ 2 ].
However, primary and acquired resistance to avelumab remains a so far unsolved clinical challenge. LoPiccolo et al. With further approved treatment options being limited to chemotherapy inducing only transient responses [ 8 ], investigation of these patients regarding subsequent ICB seems vitally important. Data were obtained from hospital records by chart review. Tissue used was collected during routine care for diagnostic or therapeutic reasons.
One of the patients was reported previously and was included with additional follow-up [ 9 ]. Representative photos, CT scans and immunohistochemistry of patient 3. The age at first MCC diagnosis ranged from 57 to 70 years. Patient demographics and outcome are summarized in Table 1.