Pembrolizumab Immunotherapy Benefits Some Merkel Cell Carcinoma Patients

MedicalResearch.com Interview with:

Paul Nghiem, MD, PhD Professor & Head, University of Washington Dermatology George F. Odland Endowed Chair Affiliate Investigator, Fred Hutchinson Cancer Research Center Professor, Adjunct, of Pathology and Oral Health Sciences Clinical Director, Skin Oncology, Seattle Cancer Care Alliance UW Medical Center at Lake Union Seattle WA 98109

Dr. Paul Nghiem

Paul Nghiem, MD, PhD
Professor & Head, University of Washington Dermatology
George F. Odland Endowed Chair
Affiliate Investigator, Fred Hutchinson Cancer Research Center
Professor, Adjunct, of Pathology and Oral Health Sciences
Clinical Director, Skin Oncology, Seattle Cancer Care Alliance
UW Medical Center at Lake Union
Seattle WA 98109

 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Nghiem: Merkel cell carcinoma (MCC) is about 30 times less common than malignant melanoma, but about 3 times more likely to kill a patient than a melanoma. There is no FDA-approved therapy for this cancer & chemotherapy typically only provides about 90 days prior to the cancer progressing. Because of the strong links between MCC and the immune system, including the fact that most MCCs are caused by a virus, there was interest in trying to use immune checkpoint therapy to treat advanced Merkel cell carcinoma. The response to immune stimulation with anti-PD1 therapy was about as frequent as to chemotherapy (56% of patients responded) but importantly, among the responders, 86% remained in ongoing responses at a median of 7.6 months.  While still early, this appears to be strikingly more durable than responses to chemotherapy.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Nghiem: The use of immune checkpoint inhibitors is likely to be the backbone of therapy for Merkel cell carcinoma going forward.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Nghiem: Nearly half of patients are not benefitting.  Hopefully the combination of other immune stimulating drugs and or radiation or even chemotherapy may help a larger fraction of patients benefit.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

PD-1 Blockade with Pembrolizumab in Advanced Merkel-Cell Carcinoma

Paul T. Nghiem, M.D., Ph.D., Shailender Bhatia, M.D., Evan J. Lipson, M.D., Ragini R. Kudchadkar, M.D., Natalie J. Miller, B.A., Lakshmanan Annamalai, D.V.M., Ph.D, Sneha Berry, M.S., Elliot K. Chartash, M.D., Adil Daud, M.B., B.S., Steven P. Fling, Ph.D., Philip A. Friedlander, M.D., Harriet M. Kluger, M.D., Holbrook E. Kohrt, M.D., Ph.D., Lisa Lundgren, M.S., Kim Margolin, M.D., Alan Mitchell, M.Sc., Thomas Olencki, D.O., Drew M. Pardoll, M.D., Ph.D., Sunil A. Reddy, M.D., Erica M. Shantha, M.D., William H. Sharfman, M.D., Elad Sharon, M.D., M.P.H., Lynn R. Shemanski, Ph.D., Michi M. Shinohara, M.D., Joel C. Sunshine, M.D., Ph.D., Janis M. Taube, M.D., John A. Thompson, M.D., Steven M. Townson, Ph.D., Jennifer H. Yearley, D.V.M., Ph.D., Suzanne L. Topalian, M.D., and Martin A. Cheever, M.D.

April 19, 2016 DOI: 10.1056/NEJMoa1603702

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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