Difference between revisions of "Merkel cell carcinoma"

From HemOnc.org - A Hematology Oncology Wiki
Jump to navigation Jump to search
(guidelines)
(added regimen)
Line 15: Line 15:
  
 
=Primary Treatment=
 
=Primary Treatment=
 +
 +
==Avelumab (Bavencio) {{#subobject:XXXXXX|Regimen=1}}==
 +
{| class="wikitable" style="float:right; margin-left: 5px;"
 +
|-
 +
|[[#top|back to top]]
 +
|}
 +
 +
===Regimen {{#subobject:XXXXXX|Variant=1}}===
 +
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|[[Overall response rate|'''ORR''']]
 +
|-
 +
|[http://thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30364-3/abstract Kaufman et al. 2016 (JAVELIN)]
 +
|style="background-color:#EEEE00"|Phase II
 +
|31.8% (95.9% CI 21.9–43.1%)
 +
|-
 +
|}
 +
====Immunotherapy====
 +
*[[Avelumab (Bavencio)]] 10 mg/kg IV over 60 minutes once on day 1
 +
 +
====Supportive medications====
 +
''Per Kaufman et al. 2016 (JAVELIN)''
 +
*[[:Category:Antihistamines|H1-antihistamine]], such as [[Diphenhydramine (Benadryl)|diphenhydramine]] (dose & route not given) 30 to 60 minutes prior to each dose of avelumab
 +
*[[Acetaminophen (Tylenol)|Paracetamol/acetaminophen]] (dose not given) 30 to 60 minutes prior to each dose of avelumab
 +
*The Avelumab package insert suggests "Premedicate with acetaminophen and an antihistamine for the first 4 infusions and subsequently as needed."
 +
 +
'''14-day cycles, given until progression of disease or unacceptable toxicity'''
 +
 +
===References===
 +
# 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. [http://thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30364-3/abstract link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/27592805 PubMed] content property of [http://hemonc.org HemOnc.org]
 +
# '''Abstract:''' Howard Kaufman, Jeffery Scott Russell, Omid Hamid, Shailender Bhatia, Patrick Terheyden, Sandra P. D'Angelo, Kent C. Shih, Celeste Lebbe, Gerald P Linette, Michele Milella, Isaac Brownell, Karl D. Lewis, Jochen H. Lorch, Kevin M. Chin, Lisa Mahnke, Anja von Heydebreck, Jean-Marie Cuillerot, Paul Nghiem. Avelumab (MSB0010718C; anti-PD-L1) in patients with metastatic Merkel cell carcinoma previously treated with chemotherapy: Results of the phase 2 JAVELIN Merkel 200 trial. 2016 ASCO Annual Meeting abstract 9508. [http://meetinglibrary.asco.org/content/168263-176 link to abstract]
  
 
==Pembrolizumab (Keytruda) {{#subobject:515cc4|Regimen=1}}==
 
==Pembrolizumab (Keytruda) {{#subobject:515cc4|Regimen=1}}==
Line 28: Line 60:
 
|[[Overall response rate|'''ORR''']]
 
|[[Overall response rate|'''ORR''']]
 
|-
 
|-
−
|[http://www.nejm.org/doi/full/10.1056/NEJMoa1603702 Nghiem al. 2016]
+
|[http://www.nejm.org/doi/full/10.1056/NEJMoa1603702 Nghiem et al. 2016]
 
|style="background-color:#EEEE00"|Phase II
 
|style="background-color:#EEEE00"|Phase II
 
|56% (95% CI 35-76%)
 
|56% (95% CI 35-76%)
Line 39: Line 71:
  
 
===References===
 
===References===
−
# 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. [http://www.nejm.org/doi/full/10.1056/NEJMoa1603702 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927341/ link to PMC article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/27093365 PubMed] content property of [http://hemonc.org HemOnc.org]
+
# 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. [http://www.nejm.org/doi/full/10.1056/NEJMoa1603702 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927341/ link to PMC article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/27093365 PubMed]
  
 
[[Category:Chemotherapy regimens]]
 
[[Category:Chemotherapy regimens]]
 
[[Category:Solid oncology regimens]]
 
[[Category:Solid oncology regimens]]

Revision as of 21:04, 23 March 2017

Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.

Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.

3 regimens on this page
3 variants on this page


Guidelines

NCCN

Primary Treatment

Avelumab (Bavencio)

back to top

Regimen

Study Evidence ORR
Kaufman et al. 2016 (JAVELIN) Phase II 31.8% (95.9% CI 21.9–43.1%)

Immunotherapy

Supportive medications

Per Kaufman et al. 2016 (JAVELIN)

  • H1-antihistamine, such as diphenhydramine (dose & route not given) 30 to 60 minutes prior to each dose of avelumab
  • Paracetamol/acetaminophen (dose not given) 30 to 60 minutes prior to each dose of avelumab
  • The Avelumab package insert suggests "Premedicate with acetaminophen and an antihistamine for the first 4 infusions and subsequently as needed."

14-day cycles, given until progression of disease or unacceptable toxicity

References

  1. 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 PubMed content property of HemOnc.org
  2. Abstract: Howard Kaufman, Jeffery Scott Russell, Omid Hamid, Shailender Bhatia, Patrick Terheyden, Sandra P. D'Angelo, Kent C. Shih, Celeste Lebbe, Gerald P Linette, Michele Milella, Isaac Brownell, Karl D. Lewis, Jochen H. Lorch, Kevin M. Chin, Lisa Mahnke, Anja von Heydebreck, Jean-Marie Cuillerot, Paul Nghiem. Avelumab (MSB0010718C; anti-PD-L1) in patients with metastatic Merkel cell carcinoma previously treated with chemotherapy: Results of the phase 2 JAVELIN Merkel 200 trial. 2016 ASCO Annual Meeting abstract 9508. link to abstract

Pembrolizumab (Keytruda)

back to top

Regimen

Study Evidence ORR
Nghiem et al. 2016 Phase II 56% (95% CI 35-76%)

Immunotherapy

21-day cycles for up to 2 years or until CR, progression, or intolerable toxicity

References

  1. 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
Retrieved from "https://hemonc.org/w/index.php?title=Merkel_cell_carcinoma&oldid=13383"