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Avelumab real-world use in advanced Merkel cell carcinoma: a systematic review and non-comparative meta-analysis

Andreas Freitag1, Zhiyi Lan2, Hoora Moradian2

  • 1Evidence, Value & Access, Cytel, Inc., London, UK.

Future Oncology (London, England)
|January 23, 2026
PubMed
Abstract

Insights

Real-world evidence shows avelumab offers significant survival benefits for advanced Merkel cell carcinoma (MCC). This immunotherapy demonstrated strong 12-month overall survival and progression-free survival rates in patients with MCC.

Area of Science:

  • Oncology
  • Immunotherapy
  • Real-World Evidence

Background:

  • Programmed death (ligand) 1 inhibitors are first-line treatments for advanced Merkel cell carcinoma (MCC).
  • Limited comparative trials necessitate real-world evidence (RWE) synthesis for advanced MCC immunotherapies.

Purpose of the Study:

  • To systematically identify and synthesize RWE on the effectiveness and safety of immunotherapies in advanced MCC.
  • To evaluate real-world outcomes for patients with locally advanced or metastatic MCC receiving immunotherapy.

Main Methods:

  • Searched MEDLINE and Embase for observational RWE studies (Jan 2017-Dec 2023) on advanced MCC.
  • Conducted a meta-analysis of 12-month overall survival (OS) and progression-free survival (PFS) for avelumab.
  • Assessed safety data from included retrospective studies.

Main Results:

  • Avelumab was the only immunotherapy with sufficient data for meta-analysis.
  • Pooled 12-month OS rates were 77.7% (Stage III) and 63.0% (Stage IV) MCC.
  • Pooled 12-month PFS rates were 53.3% (Stage III) and 39.3% (Stage IV) MCC.

Conclusions:

  • Real-world data support the effectiveness of avelumab in advanced MCC.
  • Avelumab demonstrates comparable survival outcomes to clinical trial data.
  • Safety profile in real-world settings appears favorable, warranting broader use.
Keywords:
Merkel cell carcinomaavelumabeffectivenessmeta-analysisreal-world evidencesafetysystematic literature review

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