scholarly journals Neoadjuvant Therapy for Non-melanoma Skin Cancer: Updated Therapeutic Approaches for Basal, Squamous, and Merkel Cell Carcinoma

2021 ◽  
Vol 22 (4) ◽  
Author(s):  
Enrico Zelin ◽  
Iris Zalaudek ◽  
Marina Agozzino ◽  
Caterina Dianzani ◽  
Arianna Dri ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Checkpoint Inhibitors ◽  
Locally Advanced ◽  
Merkel Cell ◽  
Non Melanoma Skin Cancer ◽  
Skin Cancers ◽  
Multiple Basal Cell Carcinomas ◽  
Melanoma Skin

Opinion statementRecently introduced systemic therapies for locally advanced and metastatic non-melanoma skin cancers (NMSCs) are paving the way for neoadjuvant approach. Although none of the therapeutic options has currently gained indication in this setting, neoadjuvant approach for NMSCs is an open field and we are likely to see huge developments in the near future. Targeted therapy with sonic hedgehog pathway inhibitors is very effective in locally advanced or multiple basal cell carcinomas while immunotherapy with immune checkpoint inhibitors appears to be promising for advanced cutaneous squamous cell carcinoma and Merkel cell carcinoma. To date, targeted therapy and immunotherapy represent the frontiers in NMSC therapeutic management and, according to recent studies, good results can be achieved.

scholarly journals Immune Checkpoint Inhibition in Non-Melanoma Skin Cancer: A Review of Current Evidence

2021 ◽  
Vol 11 ◽  
Author(s):  
Connor J. Stonesifer ◽  
A. Reza Djavid ◽  
Joseph M. Grimes ◽  
Alexandra E. Khaleel ◽  
Yssra S. Soliman ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Cutaneous Melanoma ◽  
Clinical Evidence ◽  
Checkpoint Inhibitors ◽  
Current Evidence ◽  
Checkpoint Inhibition ◽  
Non Melanoma Skin Cancer ◽  
Skin Cancers ◽  
Melanoma Patients ◽  
Melanoma Skin

Immuno-oncology is a rapidly evolving field with growing relevance in the treatment of numerous malignancies. The prior study of immunotherapy in dermatologic oncology has largely focused on cutaneous melanoma. However, recent focus has shifted to the use of immunotherapy to treat non-melanoma skin cancers (NMSCs), such as basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and Merkel cell carcinoma (MCC). NMSCs represent the most ubiquitous cancers globally and, while they have a lower propensity to develop into advanced disease than cutaneous melanoma, their absolute mortality burden has recently surpassed that of melanoma. Patients with advanced NMSC are now benefiting from the successes of immunotherapy, including checkpoint inhibition with anti-CTLA-4 and anti-PD-1 monoclonal antibodies. In this review, we discuss the existing clinical evidence for immunotherapy in the treatment of NMSCs, with an emphasis on checkpoint inhibitor therapies. We highlight key studies in the field and provide up-to-date clinical evidence regarding ongoing clinical trials, as well as future study directions. Our review demonstrates that checkpoint inhibitors are positioned to provide unparalleled results in the previously challenging landscape of advanced NMSC treatment.

Non-melanoma skin cancer and premalignant conditions

2021 ◽  
pp. 69-78
Author(s):  
Barbara Jemec ◽  
Gregor B.E. Jemec
Keyword(s):  
Squamous Cell Carcinoma ◽  
Surgical Treatment ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Merkel Cell ◽  
Non Melanoma Skin Cancer ◽  
Skin Cancers ◽  
Carcinoma Squamous Cell ◽  
Non Surgical Treatment ◽  
Melanoma Skin

This chapter describes the diagnosis, non-surgical treatment, and surgical treatment of non-melanoma skin cancers, such as basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, and others.

scholarly journals Avelumab in the treatment of patients with merkel cell carcinoma: initial results of early access program in Russia

2019 ◽  
Vol 9 (1) ◽  
pp. 53-58
Author(s):  
K. V. Orlova ◽  
V. V. Nazarova ◽  
N. N. Petenko ◽  
L. V. Demidov
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Locally Advanced ◽  
Merkel Cell ◽  
Early Access ◽  
Access Program ◽  
Initial Results

Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with limited treatment options in later stages, when the mortality rate due to the disease is as high as 46 %. It has been demonstrated earlier that MCC is an immunogenic tumor, therefore the emergence of immune checkpoint inhibitors has changed the treatment principles for patients with advanced MCC. In this article, we present the initial results of the use of avelumab, an anti‑PD–L1 antibody, in the treatment of patients with metastatic and/or locally advanced MCC as part of the early access program in Russia.

Management of Non-melanoma Skin Cancers: Merkel Cell Carcinoma

Melanoma ◽  
2018 ◽  
pp. 623-636
Author(s):  
Isabel Prieto ◽  
Teresa Pérez-de-la-Fuente ◽  
M Susana Medina ◽  
Beatriz Castelo ◽  
Fernando Cassinello ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Merkel Cell ◽  
Skin Cancers ◽  
Melanoma Skin

Merkel Cell Carcinoma Guidelines

2006 ◽  
Vol 4 (7) ◽  
pp. 704 ◽  
Keyword(s):  
Skin Cancer ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Treatment Strategies ◽  
Biomedical Literature ◽  
Merkel Cell ◽  
Recurrence Rates ◽  
Non Melanoma Skin Cancer ◽  
Recent Version ◽  
Melanoma Skin

Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous tumor that combines the local recurrence rates of infiltrative non-melanoma skin cancer with the regional and distant metastatic rates of thick melanoma. The mortality rate of MCC exceeds that of melanoma, and the 5-year disease-specific survival rate is 64%. These guidelines and most biomedical literature suggest that the workup of a patient with MCC should include chest radiograph and additional studies as clinically indicated. These guidelines, which the NCCN Non-Melanoma Skin Cancer Panel developed as a supplement to those for squamous cell and basal cell skin cancer, also outline treatment strategies. For the most recent version of the guidelines, please visit NCCN.org

Utility of concurrent immunoradiation for locally advanced and/or medically inoperable melanoma and Merkel cell carcinoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e21053-e21053
Author(s):  
Joyson Poulose ◽  
Megan Wheelden ◽  
Heath B. Mackley ◽  
Carla Schmeck ◽  
Junjia Zhu ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Checkpoint Inhibitors ◽  
Objective Response ◽  
Locally Advanced ◽  
Complete Response ◽  
Radiation Dermatitis ◽  
Merkel Cell ◽  
Operative Strategy ◽  
Grade 3

e21053 Background: Melanoma and Merkel Cell Carcinoma (MCC) are aggressive cutaneous malignancies with poor responses to cytotoxic chemotherapy. The use of immune checkpoint inhibitors (ICI) has substantially improved outcomes in metastatic disease and in the neoadjuvant setting. Addition of concurrent radiation therapy (RT) can augment the response of ICI, however there are little data on this combined approach as a neoadjuvant or non-operative strategy. Methods: We retrospectively analyzed outcomes of patients who received RT combined with an ICI against PD1, PD-L1, CTLA-4, or dual targets as neoadjuvant or definitive non-operative management for non-polymetastatic disease at our center from 2012 to 2018. Results: This study analyzed 14 patients, 7 males and 7 females, with a median age of 75 years. There were 10 patients with melanoma and 4 patients with MCC. Among them, 9 patients had stage III disease and 5 patients had oligometastatic disease. Prior treatments included surgery (71%), radiation (21%), and immunotherapy (21%) comprising interferon alpha (1), intralesional BCG (1), and Nivolumab (1). The ICI used were Pembrolizumab (5), Nivolumab (2), Avelumab (2), Ipilumumab (4) and Ipilumumab + Nivolumab (1). Immune related adverse events were seen in 8 patients and included endocrine (5), skin (4), and gastrointestinal (2) toxicity, majority of which were grade 1. Both grade 3 dermatitis and colitis were seen in 2 patients, and 1 patient had grade 3 colitis. There was 1 patient with grade 1 radiation dermatitis. Following concurrent ICI + RT, 4 patients who did not achieve a complete response (CR) at the irradiated site underwent surgical resection with no postoperative complications. An objective response at the irradiated site was seen in 13 (93%) patients, and 12 (86%) patients achieved a CR outside the radiated field. At the time of last follow up, 10 patients remain alive, of which 8 patients are in sustained complete remission. Conclusions: Concurrent use of ICI + RT was a safe approach in patients with locally advanced or medically inoperable melanoma and MCC with potential for durable complete remissions in the majority. Prospective studies are warranted to further validate this approach.

scholarly journals Radiotherapy for Metastatic Merkel Cell Carcinoma: A Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Luluel Khan ◽  
Elizabeth A. Barnes
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Case Reports ◽  
Case Series ◽  
Merkel Cell ◽  
Primary Tumors ◽  
Non Melanoma Skin Cancer ◽  
Retrospective Nature ◽  
Melanoma Skin

Introduction.Merkel cell carcinoma is a rare form of non-melanoma skin cancer of neuroendocrine origin. Optimal management of patients is controversial and the role of radiotherapy is unclear.Purpose.The purpose of this study was to review the efficacy of RT in the treatment of both local and distant metastatic disease from MCC.Methods.A literature search was conducted in MEDLINE (1946—January Week 1 2012) and Embase (1980–2012 Week 2). Articles of interest analyze the efficacy of radiotherapy for treatment of metastatic MCC and did not exclude case reports.Results.All articles except one focusing on the role of radiotherapy were of retrospective origin or case series. Significant limitations applied in all studies due to limited sample sizes and the retrospective nature of these studies. Radiotherapy improves locoregional control in the adjuvant setting, and many series suggest an improvement in overall survival. In cases where surgery is not possible, definitive radiotherapy may be an as-efficacious alternative. The radiosensitive nature of MCC coupled with existing reports suggests that treatment via current protocols for other primary tumors is adequate.Conclusion.Further studies should be conducted prospectively to clarify the true role of radiotherapy in metastatic MCC.

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