PD-L1 blockade with avelumab: A new paradigm for treating Merkel cell carcinoma
Savannah Barkdull1, Isaac Brownell1
1a Dermatology Branch, Center for Cancer Research , National Cancer Institute, NIH , Bethesda , MD , USA.
Abstract:
Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer. Until recently, no durable treatment options were available for patients with advanced disease. As an immunogenic cancer, MCC was hypothesized to be a candidate for PD-L1/PD-1 targeted therapy. On March 23, 2017 the US Food and Drug Administration granted accelerated approval for avelumab, an anti-PD-L1 monoclonal antibody, for the treatment of metastatic MCC on the basis of the JAVELIN Merkel 200 trial. Here we examine the results and implications of this pivotal study, published in Lancet Oncology by Kaufman et al., as well as current developments in the use of immune-checkpoint therapies for treating patients with MCC.
Insights
Avelumab, an anti-PD-L1 therapy, offers a new treatment for advanced Merkel cell carcinoma (MCC), a rare skin cancer. This immune-checkpoint inhibitor provides durable options for patients with previously limited choices.
Area of Science:
- Oncology
- Immunology
- Dermatology
Background:
- Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer with limited treatment options for advanced stages.
- The immunogenic nature of MCC suggested potential efficacy for immune-checkpoint therapies targeting PD-L1/PD-1 pathways.
Purpose of the Study:
- To examine the results and implications of the pivotal JAVELIN Merkel 200 trial for avelumab in metastatic MCC.
- To discuss current developments in immune-checkpoint therapies for MCC treatment.
Main Methods:
- Review of the JAVELIN Merkel 200 trial data published in Lancet Oncology.
- Analysis of avelumab's accelerated approval by the US FDA for metastatic MCC.
- Examination of ongoing research in immune-checkpoint inhibitors for MCC.
Main Results:
- Avelumab, an anti-PD-L1 monoclonal antibody, received accelerated FDA approval for metastatic MCC.
- The JAVELIN Merkel 200 trial demonstrated the efficacy of avelumab in this patient population.
- Immune-checkpoint therapy represents a significant advancement in MCC treatment.
Conclusions:
- Avelumab provides a durable treatment option for advanced Merkel cell carcinoma.
- Immune-checkpoint inhibitors are transforming the therapeutic landscape for MCC.
- Further research continues to evolve the use of these therapies in MCC.
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