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.
Merkel cell carcinoma (MCC) is an aggressive skin cancer that recurs in more than one-third of cases, with reported mortality rates of 33% to 46%.1 Given this high-risk situation, MCC is often managed with therapies that are aggressive and potentially toxic: extensive surgery, radiation therapy (RT), and systemic therapy. Fortunately, recent advances in multiple realms now allow MCC management to be more effective and less toxic. In this Viewpoint, we highlight 3 recent developments relating to progress in local management, early detection of recurrent disease, and systemic therapy. Although it is not practical for physicians who rarely see patients with MCC to remain up-to-date on the details of management, herein we provide resources and guidelines to help physicians ensure optimal initial care and participate in longitudinal treatment of patients with MCC.