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Immunotherapy of Merkel Cell Carcinoma

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Handbook of Cancer and Immunology

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Abstract

Merkel cell carcinoma is a fast-growing neuroendocrine neoplasm with a low frequency of occurrence. The diagnosis and treatment should be managed by an experienced multidisciplinary team. The disease at a low stage may be curable. Radical treatment includes surgery with possible radiotherapy and, less frequently, perioperative chemotherapy. The risk of recurrence is high. In unresectable or metastatic disease, the standard of care was previously chemotherapy, as the tumor cells are very sensitive to cytotoxic drugs. The main problem is a high rate of secondary resistance to chemotherapy. Based on the pivotal clinical trials, the new standard of care in advanced and metastatic disease is immunotherapy (avelumab and pembrolizumab). Avelumab is the first immune check point inhibitor approved for metastatic Merkel cell carcinoma in the USA and Europe. This medicine allows for long-term response in above 30% of patients. The predictive factors of response are unknown. Pembrolizumab has been approved only in the USA for advanced and metastatic disease. There are currently ongoing clinical trials to further improve the treatment outcomes in the advanced and metastatic settings, including studies to overcome the resistance to checkpoint inhibitors, as well as trials with immunotherapy in a preoperative setting to reduce the risk of disease recurrence.

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Authors and Affiliations

  1. Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

    Monika Dudzisz-Śledź, Martyna Zwierzchowska, Elżbieta Bylina, Piotr Rutkowski & Anna M. Czarnecka

  2. Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland

    Martyna Zwierzchowska

  3. Department of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

    Elżbieta Bylina

  4. Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland

    Anna M. Czarnecka

Authors
  1. Monika Dudzisz-Śledź
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  2. Martyna Zwierzchowska
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  3. Elżbieta Bylina
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  4. Piotr Rutkowski
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  5. Anna M. Czarnecka
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Corresponding author

Correspondence to Monika Dudzisz-Śledź .

Editor information

Editors and Affiliations

  1. Division of Clinical Immunology, Karolinska University Hospital, Huddinge, Sweden

    Nima Rezaei

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Dudzisz-Śledź, M., Zwierzchowska, M., Bylina, E., Rutkowski, P., Czarnecka, A.M. (2023). Immunotherapy of Merkel Cell Carcinoma. In: Rezaei, N. (eds) Handbook of Cancer and Immunology. Springer, Cham. https://doi.org/10.1007/978-3-030-80962-1_247-1

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  • DOI: https://doi.org/10.1007/978-3-030-80962-1_247-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-80962-1

  • Online ISBN: 978-3-030-80962-1

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

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