Perspectives on 10 years of Immune Checkpoint Inhibitors in Merkel Cell Carcinoma: A Podcast

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Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a poor prognosis, particularly in patients with advanced disease. The introduction of immune checkpoint inhibitors (ICIs) approximately 10 years ago has dramatically improved outcomes for patients with advanced MCC. Current US Food and Drug Administration-approved ICIs in this setting include the PD-L1 inhibitor avelumab and PD-1 inhibitors pembrolizumab and retifanlimab. In this podcast, we summarize key studies of ICIs in advanced MCC, including clinical trials and real-world studies, and discuss clinical evidence related to practical considerations, such as elective discontinuation of ICI treatment, and treatment of patients with immunocompromised or immunosuppressed status. We also discuss initial findings from studies of ICI-based combinations in patients with advanced MCC and ICI treatment in earlier stages of MCC, and highlight the emerging role of circulating tumor DNA for predicting disease recurrence. Overall, these developments demonstrate the positive impact of ICIs in the treatment of MCC and illustrate ongoing efforts to further improve patient outcomes. Merkel cell cancer (MCC) is a rare skin cancer that can grow and spread quickly. In people with advanced MCC, which means that the cancer has spread to other parts of the body, available treatments often did not work well in the past. Since 2016, clinical studies have shown that medicines called immune checkpoint inhibitors (ICIs) are much more effective than older treatments for advanced MCC. ICIs work by helping the body’s immune system recognize and attack cancer cells. Studies have shown that ICIs can help people live longer. Examples of ICIs include avelumab, pembrolizumab, and retifanlimab. In this podcast, three expert doctors discuss results from studies of ICIs in advanced MCC. This includes clinical trials as well as observational studies, which examine results from routine medical care. They also explore topics that doctors face in everyday clinical practice, including what to do if ICI treatment is not working and whether ICIs may be effective in earlier stages of MCC, before the cancer has spread to distant parts of the body. Newer clinical trials seeking to answer these questions are also discussed. Overall, study findings show that ICIs have been an important development for people with advanced MCC. Ongoing and future studies aim to build on this progress, with the hope of further improving outcomes for people with advanced MCC.