Abstract
Background
The immune system is extremely important in the development and progression of Merkel cell carcinoma (MCC). Immune checkpoint blockade has recently been shown to enable efficacious treatment of a variety of tumours. We report use of an anti-PD-1 antibody for treatment of a patient with metastatic MCC.
Case Report
An 80-year-old patient with metastatic MCC received off-label treatment with the anti-PD-1 antibody pembrolizumab after the disease had progressed during therapy with oral etoposide. A PET-CT scan performed after three cycles of pembrolizumab revealed response to therapy with reduced size of the adrenal gland metastases and less PET activity in the adrenal gland and lymph node metastases. Further on, treatment was resumed due to disease progression in a treatment-free interval of more than four months. During subsequent months of treatment size of the metastases stabilized and uptake of nuclide by all tumour sites once again decreased.
Conclusions
These results reveal the potential efficacy of an anti-PD-1 antibody for treatment of metastatic MCC. They thus contribute to currently limited data on use of anti-PD-1 antibodies for treatment of MCC. This is, moreover, the first report of successful resumption of treatment of metastatic MCC with an anti-PD-1 antibody. Results from ongoing trials will contribute to determination of the relevance of PD-1 blockade in metastatic MCC.
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