Difference between revisions of "Merkel cell carcinoma"
Jump to navigation
Jump to search
Warner-admin (talk | contribs) m (Text replacement - "{| class="wikitable sortable" style="width: 100%; text-align:center;" !style="width: 25%"|Study !style="width: 25%"|Years of enrollment !style="width: 25%"|Evidence !style="width: 25%"|Efficacy" to "{| class="wikitable sortable" style="width: 80%; text-align:center;" !style="width: 25%"|Study !style="width: 25%"|Years of enrollment !style="width: 25%"|Evidence !style="width: 2...) |
m |
||
| Line 1: | Line 1: | ||
| + | <span id="BackToTop"></span> | ||
| + | <div class="noprint" style="background-color:LightGray; position:fixed; bottom:2%; right:0.25%; padding-left:5px; padding-right:5px; margin: 15px; opacity:0.8; border-style: solid; border-color:DarkGray; border-width: 1px"> | ||
| + | [[#top|Back to Top]] | ||
| + | </div> | ||
{| class="wikitable" style="text-align:center; width:50%;" | {| class="wikitable" style="text-align:center; width:50%;" | ||
!colspan="2" align="center" style="color:white; font-size:125%; background-color:#08519c"|'''Section editor''' | !colspan="2" align="center" style="color:white; font-size:125%; background-color:#08519c"|'''Section editor''' | ||
| Line 35: | Line 39: | ||
|2014-2015 | |2014-2015 | ||
|style="background-color:#91cf61"|Phase 2 (RT) | |style="background-color:#91cf61"|Phase 2 (RT) | ||
| − | | | + | |33% (95% CI: 23–44)<sup>1</sup> |
|- | |- | ||
|} | |} | ||
| + | ''<sup>1</sup>Reported efficacy is based on the 2020 update.'' | ||
====Immunotherapy==== | ====Immunotherapy==== | ||
*[[Avelumab (Bavencio)]] 10 mg/kg IV over 60 minutes once on day 1 | *[[Avelumab (Bavencio)]] 10 mg/kg IV over 60 minutes once on day 1 | ||
| Line 53: | Line 58: | ||
## '''Update:''' Kaufman HL, Russell JS, Hamid O, Bhatia S, Terheyden P, D'Angelo SP, Shih KC, Lebbé C, Milella M, Brownell I, Lewis KD, Lorch JH, von Heydebreck A, Hennessy M, Nghiem P. Updated efficacy of avelumab in patients with previously treated metastatic Merkel cell carcinoma after ≥1 year of follow-up: JAVELIN Merkel 200, a phase 2 clinical trial. J Immunother Cancer. 2018 Jan 19;6(1):7. [https://jitc.biomedcentral.com/articles/10.1186/s40425-017-0310-x link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774167/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29347993 PubMed] | ## '''Update:''' Kaufman HL, Russell JS, Hamid O, Bhatia S, Terheyden P, D'Angelo SP, Shih KC, Lebbé C, Milella M, Brownell I, Lewis KD, Lorch JH, von Heydebreck A, Hennessy M, Nghiem P. Updated efficacy of avelumab in patients with previously treated metastatic Merkel cell carcinoma after ≥1 year of follow-up: JAVELIN Merkel 200, a phase 2 clinical trial. J Immunother Cancer. 2018 Jan 19;6(1):7. [https://jitc.biomedcentral.com/articles/10.1186/s40425-017-0310-x link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774167/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29347993 PubMed] | ||
## '''Update:''' D'Angelo SP, Russell J, Lebbé C, Chmielowski B, Gambichler T, Grob JJ, Kiecker F, Rabinowits G, Terheyden P, Zwiener I, Bajars M, Hennessy M, Kaufman HL. Efficacy and safety of first-line avelumab treatment in patients with stage IV metastatic Merkel cell carcinoma: a preplanned interim analysis of a clinical trial. JAMA Oncol. 2018 Sep 1;4(9):e180077. Epub 2018 Sep 13. [https://jamanetwork.com/journals/jamaoncology/fullarticle/2675910 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885245/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29566106 PubMed] | ## '''Update:''' D'Angelo SP, Russell J, Lebbé C, Chmielowski B, Gambichler T, Grob JJ, Kiecker F, Rabinowits G, Terheyden P, Zwiener I, Bajars M, Hennessy M, Kaufman HL. Efficacy and safety of first-line avelumab treatment in patients with stage IV metastatic Merkel cell carcinoma: a preplanned interim analysis of a clinical trial. JAMA Oncol. 2018 Sep 1;4(9):e180077. Epub 2018 Sep 13. [https://jamanetwork.com/journals/jamaoncology/fullarticle/2675910 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885245/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29566106 PubMed] | ||
| + | ##'''Update:''' D'Angelo SP, Bhatia S, Brohl AS, Hamid O, Mehnert JM, Terheyden P, Shih KC, Brownell I, Lebbé C, Lewis KD, Linette GP, Milella M, Georges S, Shah P, Ellers-Lenz B, Bajars M, Güzel G, Nghiem PT. Avelumab in patients with previously treated metastatic Merkel cell carcinoma: long-term data and biomarker analyses from the single-arm phase 2 JAVELIN Merkel 200 trial. J Immunother Cancer. 2020 May;8(1):e000674. [https://doi.org/10.1136/jitc-2020-000674 link to original article] [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7239697/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/32414862/ PubMed] | ||
==Pembrolizumab monotherapy {{#subobject:515cc4|Regimen=1}}== | ==Pembrolizumab monotherapy {{#subobject:515cc4|Regimen=1}}== | ||
Revision as of 00:05, 13 July 2022
| Section editor | |
|---|---|
 |
Elizabeth Buchbinder, MD Dana-Farber Cancer Institute Boston, MA |
3 regimens on this page
3 variants on this page
|
Guidelines
Alberta Health Services
- 2019: Merkel Cell Carcinoma
NCCN
Metastatic or advanced disease, all lines of therapy
Avelumab monotherapy
| back to top |
Regimen
| Study | Years of enrollment | Evidence | Efficacy |
|---|---|---|---|
| Kaufman et al. 2016 (JAVELIN Merkel 200) | 2014-2015 | Phase 2 (RT) | 33% (95% CI: 23–44)1 |
1Reported efficacy is based on the 2020 update.
Immunotherapy
- Avelumab (Bavencio) 10 mg/kg IV over 60 minutes once on day 1
Supportive medications
- H1-antihistamine, such as diphenhydramine (dose & route not given) once on day 1, 30 to 60 minutes prior to Avelumab (Bavencio)
- Paracetamol/acetaminophen (dose not given) once on day 1, 30 to 60 minutes prior to Avelumab (Bavencio)
- The Bavencio package insert suggests "Premedicate with acetaminophen and an antihistamine for the first 4 infusions and subsequently as needed."
14-day cycles
References
- JAVELIN Merkel 200: Kaufman HL, Russell J, Hamid O, Bhatia S, Terheyden P, D'Angelo SP, Shih KC, Lebbé C, Linette GP, Milella M, Brownell I, Lewis KD, Lorch JH, Chin K, Mahnke L, von Heydebreck A, Cuillerot JM, Nghiem P. Avelumab in patients with chemotherapy-refractory metastatic Merkel cell carcinoma: a multicentre, single-group, open-label, phase 2 trial. Lancet Oncol. 2016 Oct;17(10):1374-1385. link to original article contains verified protocol link to PMC article PubMed content property of HemOnc.org NCT02155647
- Update: Kaufman HL, Russell JS, Hamid O, Bhatia S, Terheyden P, D'Angelo SP, Shih KC, Lebbé C, Milella M, Brownell I, Lewis KD, Lorch JH, von Heydebreck A, Hennessy M, Nghiem P. Updated efficacy of avelumab in patients with previously treated metastatic Merkel cell carcinoma after ≥1 year of follow-up: JAVELIN Merkel 200, a phase 2 clinical trial. J Immunother Cancer. 2018 Jan 19;6(1):7. link to original article link to PMC article PubMed
- Update: D'Angelo SP, Russell J, Lebbé C, Chmielowski B, Gambichler T, Grob JJ, Kiecker F, Rabinowits G, Terheyden P, Zwiener I, Bajars M, Hennessy M, Kaufman HL. Efficacy and safety of first-line avelumab treatment in patients with stage IV metastatic Merkel cell carcinoma: a preplanned interim analysis of a clinical trial. JAMA Oncol. 2018 Sep 1;4(9):e180077. Epub 2018 Sep 13. link to original article link to PMC article PubMed
- Update: D'Angelo SP, Bhatia S, Brohl AS, Hamid O, Mehnert JM, Terheyden P, Shih KC, Brownell I, Lebbé C, Lewis KD, Linette GP, Milella M, Georges S, Shah P, Ellers-Lenz B, Bajars M, Güzel G, Nghiem PT. Avelumab in patients with previously treated metastatic Merkel cell carcinoma: long-term data and biomarker analyses from the single-arm phase 2 JAVELIN Merkel 200 trial. J Immunother Cancer. 2020 May;8(1):e000674. link to original article link to PMC article PubMed
Pembrolizumab monotherapy
| back to top |
Regimen
| Study | Years of enrollment | Evidence | Efficacy |
|---|---|---|---|
| Nghiem et al. 2016 (KEYNOTE-017) | 2015 | Phase 2 (RT) | 56% (95% CI 35-76%) |
Immunotherapy
- Pembrolizumab (Keytruda) 2 mg/kg IV once on day 1
21-day cycle for up to 35 cycles (2 years) or until CR
References
- KEYNOTE-017: Nghiem PT, Bhatia S, Lipson EJ, Kudchadkar RR, Miller NJ, Annamalai L, Berry S, Chartash EK, Daud A, Fling SP, Friedlander PA, Kluger HM, Kohrt HE, Lundgren L, Margolin K, Mitchell A, Olencki T, Pardoll DM, Reddy SA, Shantha EM, Sharfman WH, Sharon E, Shemanski LR, Shinohara MM, Sunshine JC, Taube JM, Thompson JA, Townson SM, Yearley JH, Topalian SL, Cheever MA. PD-1 blockade with pembrolizumab in advanced Merkel-cell carcinoma. N Engl J Med. 2016 Jun 30;374(26):2542-52. Epub 2016 Apr 19. link to original article link to PMC article contains verified protocol PubMed NCT02267603