Dr. Nghiem on Challenges With Immunotherapy in Merkel Cell Carcinoma

Paul Nghiem, MD, PhD, Michael Piepkorn Endowed Chair in Dermatology Research, professor of Dermatology/Medicine at Fred Hutchinson Cancer Research Center, University of Washington Medicine, discusses challenges with immunotherapy in patients with Merkel cell carcinoma (MCC).

The 2-year efficacy and safety results from part A of the JAVELIN Merkel 200 study showed that the anti—PD-L1 monoclonal antibody avelumab (Bavencio) induced durable responses and meaningful survival outcomes in patients with metastatic MCC. These findings, which were presented at the 2018 ASCO Annual Meeting, showed a confirmed overall response rate of 33%.

Nghiem says that the next step in metastatic MCC is figuring out how to treat those who do not respond to either chemotherapy or single-agent immunotherapy. There is no go-to or obvious consensus on how these patients should be treated. Additionally, there is no way to predict who will or will not respond to immunotherapy in MCC. That being said, 60% of patients will respond and stay in response to their first-line treatment, so the proportion of patients who do not respond is a relatively small population.