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Hypercalcaemia due to Sarcoidosis during Treatment with Avelumab for Metastatic Merkel Cell Carcinoma
Sandy Tun Min1, Ina I C Nordman1,2, Huy A Tran2,3
1Department of Medical Oncology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia.
Abstract:
Merkel cell carcinoma is a rare but aggressive skin cancer. Response to chemotherapy is not durable but avelumab, an anti-PD-L1 inhibitor, showed promising ongoing response in a phase II trial. Checkpoint inhibitors including avelumab are known to cause overactivation of the immune system, leading to immune-related adverse events (irAE). We describe the first reported case of hypercalcaemia secondary to reactivation of sarcoidosis in a patient with metastatic Merkel cell carcinoma on avelumab. Hypercalcaemia was managed with corticosteroids to full resolution and avelumab therapy was safely continued.
Insights
Avelumab, an immunotherapy for Merkel cell carcinoma, can cause immune-related adverse events. This case report details hypercalcemia from sarcoidosis reactivation, successfully managed with steroids while continuing avelumab treatment.
Area of Science:
- Oncology
- Immunology
- Dermatology
Background:
- Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer with limited durable treatment options.
- Chemotherapy offers transient responses in MCC, whereas avelumab (anti-PD-L1) shows promising sustained responses in Phase II trials.
- Immune checkpoint inhibitors like avelumab can trigger immune-related adverse events (irAEs) due to immune system overactivation.
