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Advances in Management of Merkel Cell Carcinoma in Organ Transplant Recipients: Role of Polyoma Virus and Immunosuppression

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Advances in Transplant Dermatology

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Abstract

Merkel cell carcinoma (MCC) is a rare and aggressive primary cutaneous neoplasm with a high incidence of local recurrence as well as propensity for regional and systemic metastasis. Mortality rates are high with 5-year survival rates ranging from 29 % up to 74 %. Evidence demonstrates that the immune system is intimately involved with tumor development and progression. The hypothesis that a viral oncogene may play a causative role stemmed from this observation and led to the discovery of a new polyomavirus, designated Merkel cell polyomavirus (MCPyV). Up to 10 % of MCCs are found in the setting of decreased immunity. Organ transplant recipients tend to develop MCCs at an earlier age and show decreased MCC-specific and overall survival when compared to the general population. Mechanism-based therapies and viral antigen–directed therapies are in the early stages of development but show promise as targeted therapies.

Drs. Serowka, Arron, and Yu participated in the drafting of the manuscript and critical revision for important intellectual content. Dr. Serowka has no relevant financial disclosures. Dr. Yu is a paid investigator for Oncosec. Dr. Arron is supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number KL2 TR000143. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Acknowledgement

I would like to acknowledge Anna Cogen for her help with this part of the manuscript.

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Authors and Affiliations

  1. Department of Dermatology, University of California – Irvine, Irvine, CA, USA

    Kathryn Serowka MD

  2. Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA

    Sarah Arron MD, PhD & Siegrid S. Yu MD

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  1. Kathryn Serowka MD
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  2. Sarah Arron MD, PhD
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  3. Siegrid S. Yu MD
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Correspondence to Kathryn Serowka MD .

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Editors and Affiliations

  1. Transplant Dermatology, Piedmont Transplant Institute, Dermatology Consultants, PC, Atlanta, Georgia, USA

    Fiona Zwald

  2. Department of Dermatology, University of Rochester, Rochester, New York, USA

    Marc D. Brown

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Serowka, K., Arron, S., Yu, S.S. (2015). Advances in Management of Merkel Cell Carcinoma in Organ Transplant Recipients: Role of Polyoma Virus and Immunosuppression. In: Zwald, F., Brown, M. (eds) Advances in Transplant Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-12445-2_8

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