Merkel Cell Carcinoma

The Evolving Treatment Landscape of Merkel Cell Carcinoma

Our team based in Seattle conducted a comprehensive review including evolving trends in the management of Merkel cell carcinoma (MCC). This summary covers key decision points, including recommended work-up during initial diagnosis, treatment options for MCC when it’s in one place or has spread, management of recurrent MCC, and new treatments that are showing promise with fewer side effects and good results. This review gives valuable information on how to handle MCC overall and emphasizes new methods that are effective and less toxic on patients.

Management and Prognosis of Cardiac Metastatic Merkel Cell Carcinoma: A Case–Control Study and Literature Review

This case study looks at 9 patients who developed cardiac metastases, a tricky situation on which very little data is currently available. We hope that by describing 9 cases, this will provide an easily accessible road map for clinicians around the world when this difficult situation arises. In many cases, the combination of limited ‘palliative’ radiation with immune therapy proved beneficial.

Merkel cell carcinoma can be indolent: A case with 7 locoregional recurrences over 15 years highlights the importance of patient-tailored management

Patients who experience a recurrence of their Merkel cell carcinoma are often treated aggressively. We report a case of a man with an unusually long course of MCC over 15 years who had his MCC recur around his face or neck 7 times before eventually developing distant spread. Because he had 4 major medical problems at the time his MCC initially appeared, less aggressive therapies were chosen for his recurrences, and there was no evidence of disease for the vast majority of his 15-year course, during which he enjoyed excellent quality of life. This case emphasizes the importance of customizing care in MCC to give patients the best quality and quantity of life possible in their particular situation.

T cell receptor fingerprinting enables in-depth characterization of the interactions governing recognition of peptide–MHC complexes

The antigen specificity of T cells is conferred by the TCR’s highly variable complementarity-determining regions (CDRs), which interact with the pMHC4. Cellular immunity requires a pool of naive T cells (the T-cell repertoire) that can recognize a multitude of potential pMHC antigens that may originate from infections or cellular transformation. If a given TCR could recognize only a single combination of peptide and MHC, an individual would need >1015 CD8+ T cells to provide efficient coverage of all potential foreign peptides, whereas it is estimated that an individual has only around 107–108 different T cells5–7. The promiscuity of TCRs allows the recognition of numerous different pMHCs by each T cell, which broadens the recognition space and ensures the effective recognition of most possible targets.
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