Avelumab in Electrochemotherapy-Resistant Merkel Cell Carcinoma: Case Report
Posted: Friday, September 17, 2021
A case report presented in Frontiers in Oncology described a patient with PD-L1–negative Merkel cell carcinoma who achieved a complete response associated with the monoclonal antibody avelumab after the patient failed to respond to electrochemotherapy. This is believed to be the first recorded instance of a patient experiencing complete tumor remission after receiving anti–PD-L1 monoclonal antibody treatment following electrochemotherapy.
“This case report, although inherently anecdotal in its nature, suggests that [immune checkpoint inhibitors] are a potential therapeutic option for patients with [Merkel cell carcinoma] who are nonresponsive to [electrochemotherapy] and that the treatment sequence of [electrochemotherapy] followed by immunotherapy may improve clinical outcome,” concluded Sara Pusceddu, MD, of the Fondazione IRCCS Istituto Nazionale dei Tumori in Italy, and colleagues.
In January 2019, an 80-year-old man presented with a rapidly growing lesion on his right cheek. The lesion was surgically debulked. Following that procedure, the patient presented with localized pain, hearing loss, and a preauricular sensitivity deficit on the right side. Immunohistochemical staining revealed indicators consistent with Merkel cell carcinoma. When the patient returned 2 months later for a physical examination, a new irregular lesion near the scar from the previous surgery was noted; a CT scan showed malignant preauricular disease. Electrochemotherapy was begun in April 2019 following increased discomfort and loss of appetite.
A CT scan confirmed significant disease progression into the cervical region in July 2019. In August 2019, the patient began receiving a biweekly regimen of avelumab. After the first dose of avelumab, the size of the lesion was observed to have decreased significantly. After the third dose, a complete response was achieved. The patient continued receiving avelumab and was experiencing an ongoing complete response as of October 2019.
Disclosure: For full disclosures of the study authors, visit frontiersin.org.
