Pembrolizumab and other immune checkpoint inhibitors in locally advanced or metastatic Merkel Cell Carcinoma: safety and efficacy

Merkel Cell Carcinoma is a rare and aggressive skin cancer affecting elderly patients. In advanced cases, cytotoxic chemotherapies are transiently effective, with high toxicity.

PD-1/PD-L1 inhibitors allow objective responses in 50% of patients with advanced disease, with durable responses and manageable safety profile.

Avelumab was the first systemic therapy to be approved for metastatic patients, and pembrolizumab was granted FDA approval in December 2018.

PD-1/PD-L1 inhibitors are recommended as first-line treatments for metastatic Merkel Cell Carcinoma in the most recent guidelines. Real-life experiences tend to confirm the efficacy/safety profile.

There are still no reproducible predictive biomarkers to select optimal candidates for immunotherapies. Patients with good overall performance status and n…