4.3 Review

Current and preclinical treatment options for Merkel cell carcinoma

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TAYLOR & FRANCIS LTD
DOI: 10.1080/14712598.2023.2257603

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Merkel cell polyomavirus; Merkel cell carcinoma; immune checkpoint inhibition; tumor-specific T cells; p53; vaccination

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Merkel cell carcinoma is a rare and highly aggressive form of skin cancer with unclear origin, but recent research has identified two distinct etiologic pathways. The significance of MCC research and the need for advancement in MCC treatment are highlighted due to its high mortality rate and limited therapeutic options.
IntroductionMerkel cell carcinoma (MCC) is a rare, highly aggressive form of skin cancer with neuroendocrine features. The origin of this cancer is still unclear, but research in the last 15 years has demonstrated that MCC arises via two distinct etiologic pathways, i.e. virus and UV-induced. Considering the high mortality rate and the limited therapeutic options available, this review aims to highlight the significance of MCC research and the need for advancement in MCC treatment.Areas coveredWith the advent of the immune checkpoint inhibitor therapies, we now have treatment options providing a survival benefit for patients with advanced MCC. However, the issue of primary and acquired resistance to these therapies remains a significant concern. Therefore, ongoing efforts seeking additional therapeutic targets and approaches for MCC therapy are a necessity. Through a comprehensive literature search, we provide an overview on recent preclinical and clinical studies with respect to MCC therapy.Expert opinionCurrently, the only evidence-based therapy for MCC is immune checkpoint blockade with anti-PD-1/PD-L1 for advanced patients. Neoadjuvant, adjuvant and combined immune checkpoint blockade are promising treatment options.

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