Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

30 April 2018 : Case report  USA

Clinical Benefit from Tyrosine Kinase Inhibitors in Metastatic Merkel Cell Carcinoma: A Case Series of 5 Patients

Unusual or unexpected effect of treatment, Rare disease

Erica S. Tarabadkar1ABCDEF*, Hannah Thomas1ABDEF, Astrid Blom2ABCDE, Upendra Parvathaneni3CDE, Thomas Olencki4BCDEF, Paul Nghiem1ABCDEFG, Shailender Bhatia5ABCDEFG

DOI: 10.12659/AJCR.908649

Am J Case Rep 2018; 19:505-511

Abstract

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

Add Comment 0 Comments

In Press

Case report  Saudi Arabia

Corneal Ring Infiltrate Following Micropulse Cyclophotocoagulation

Am J Case Rep In Press; DOI: 10.12659/AJCR.945852  

Case report  Greece

Mesosigmoid Fossa Herniation: A Case of Jejunal Obstruction

Am J Case Rep In Press; DOI: 10.12659/AJCR.944817  

Case report  China

Right Bundle Branch Block on ECG as a Predictor of Sudden Cardiac Arrest Due to Pulmonary Embolism

Am J Case Rep In Press; DOI: 10.12659/AJCR.946074  

Case report  USA

A 20-Year-Old Woman with Metachronous Polyostotic Simple (Unicameral) Bone Cysts in 9 Sites: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.946165  

Most Viewed Current Articles

21 Jun 2024 : Case report  China (mainland) 89,036

Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...

DOI :10.12659/AJCR.944371

Am J Case Rep 2024; 25:e944371

0:00

07 Mar 2024 : Case report  USA 50,209

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

20 Nov 2023 : Case report  Saudi Arabia 25,680

Azithromycin Treatment for Acne Vulgaris: A Case Report on the Risk of Clostridioides difficile Infection

DOI :10.12659/AJCR.941424

Am J Case Rep 2023; 24:e941424

0:00

18 Feb 2024 : Case report  Japan 22,688

A Case of Thoracic Empyema Caused by Actinomyces naeslundii

DOI :10.12659/AJCR.943030

Am J Case Rep 2024; 25:e943030

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923