30 April 2018 : Case report
Clinical Benefit from Tyrosine Kinase Inhibitors in Metastatic Merkel Cell Carcinoma: A Case Series of 5 Patients
Unusual or unexpected effect of treatment, Rare diseaseErica S. Tarabadkar1ABCDEF*, Hannah Thomas1ABDEF, Astrid Blom2ABCDE, Upendra Parvathaneni3CDE, Thomas Olencki4BCDEF, Paul Nghiem1ABCDEFG, Shailender Bhatia5ABCDEFG
Am J Case Rep 2018; 19:505-511
BACKGROUND: Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine skin cancer. The estimated 5-year survival of patients with metastatic disease is approximately 14%. Cytotoxic chemotherapy is associated with a modest median progression-free survival (PFS) of only 3 months. In recent studies, immunotherapy with anti-PD-1/anti-PD-L1 antibodies has demonstrated a high response rate in immunocompetent patients (>50% in chemotherapy-naïve patients) and responses are typically durable. However, approximately 50% of immunocompetent patients do not respond to immunotherapy. In addition, immunosuppressed patients have limited therapeutic options. Hence, there is a significant unmet need for effective treatments in these subpopulations.
CASE REPORT: We describe 5 patients (out of 24 total) with metastatic MCC who were treated with a vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI), either pazopanib (n=4) or cabozantinib (n=1), with clinical benefit. One patient had a complete response to pazopanib after 3 months of therapy. Four patients had stabilization of disease that lasted from 5 months to 3.5 years. In an immunosuppressed patient with psoriatic arthritis, stabilization of MCC was also associated with improvement in his arthritis that allowed cessation of immunosuppression. Patients did not develop any unusual toxicities from VEGFR-TKIs.
CONCLUSIONS: Treatment with VEGFR-TKIs demonstrated clinical benefit in this selected small group of patients with metastatic MCC. Prospective investigation of VEGFR-TKIs is warranted in this population, especially in patients with disease refractory to immunotherapy.
Keywords: Carcinoma, Merkel Cell, Immunotherapy, Programmed Cell Death 1 Receptor, Receptors, Vascular Endothelial Growth Factor
31 May 2023 : Case reportPreoperative Clinical Prediction of Parathyroid Carcinoma: Two Rare Case Presentations and a Review of Lite...
Am J Case Rep In Press; DOI: 10.12659/AJCR.940611
31 May 2023 : Case reportInflammatory Arthritis After COVID-19: A Case Series
Am J Case Rep In Press; DOI: 10.12659/AJCR.939870
31 May 2023 : Case reportCondyle Fracture Fixed with Custom-Made Titanium Mesh and a Miniplate: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.940681
31 May 2023 : Case reportThe Reemerging Condition of Vaccinia: A Case Report and Brief Review of Monkeypox and Vaccinia Vaccines
Am J Case Rep In Press; DOI: 10.12659/AJCR.941006
Most Viewed Current Articles
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441
07 Dec 2021 : Case reportEdwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...
Am J Case Rep 2021; 22:e934347
23 Feb 2022 : Case reportPenile Necrosis Associated with Local Intravenous Injection of Cocaine
Am J Case Rep 2022; 23:e935250