ASO Author Reflections: Neoadjuvant Immunotherapy for Merkel Cell Carcinoma with Clinically Detected Regional Lymph Node Metastasis?

Merkel cell carcinoma (MCC), although rare, is a clinically aggressive cutaneous malignancy.Prognosis and management of MCC are heavily contingent on the extent of nodal involvement.Patients with clinically detected nodal disease (stage IIIB) have historically had low rates of overall survival because of limited systemic treatment options.However, recent findings from clinical trials in other cutaneous malignancies suggest a role for neoadjuvant immunotherapy (NIO). 1,2It is thought that dual activation of the immune system within both the tumor tissue and its microenvironment may result in a more robust host immune response prior to the surgical removal of the tumor. 3The most recent trends of NIO use in MCC with clinically detected lymph node metastasis and the impact of NIO on overall survival for these patients have yet to be explored.