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A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Fatal outcome after immunotherapy in metastatic Merkel cell carcinoma of unknown primary cause
Yohan Depierre1, Amina Faiza Chouiter-Djebaili2, Hervé Zender1,3,4
1Service of Internal Medicine, Department of Medicine, Network Hospital Neuchâtel, La Chaux-de-Fonds, Switzerland.
Abstract:
Merkel cell carcinoma (MCC) is a rare form of skin cancer characterised by a high mortality rate. Despite limited evidence regarding the treatment of metastatic MCC, anti-programmed cell death protein 1 immunotherapy has emerged as a primary strategy for managing advanced stages of the disease. This report presents the case of a woman in her early 80s with stage IV MCC after consultation for declining general health, with the primary lesion remaining unidentified. Pembrolizumab therapy was initiated, which led to acute renal failure after the first infusion. The case highlights the high pathogenicity of MCC and the risk of renal complication associated with pembrolizumab, underscoring the need for vigilance in anticipating and preventing such adverse effects. The discussion examines recent recommendations on the best treatment options for metastatic MCC, which currently includes immunotherapy.
Insights
Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer. Immunotherapy with pembrolizumab can be effective but carries a risk of acute renal failure, requiring careful patient monitoring.
Area of Science:
- Oncology
- Immunology
- Nephrology
Background:
- Merkel cell carcinoma (MCC) is a rare but aggressive skin cancer with high mortality.
- Metastatic MCC treatment options are limited, with anti-programmed cell death protein 1 (PD-1) immunotherapy now a primary strategy.
Purpose of the Study:
- To report a case of stage IV MCC treated with pembrolizumab.
- To highlight the potential risk of acute renal failure associated with pembrolizumab therapy in MCC patients.
Main Methods:
- Case report of an elderly female patient with stage IV MCC.
- Initiation of pembrolizumab therapy for metastatic disease.
- Monitoring for adverse events, specifically renal complications.
Main Results:
- The patient developed acute renal failure after the first pembrolizumab infusion.
- This case underscores the high pathogenicity of MCC and potential immunotherapy-related adverse events.
Conclusions:
- Pembrolizumab is a key treatment for advanced MCC but requires vigilant monitoring for renal complications.
- Proactive management is crucial to anticipate and prevent adverse effects during immunotherapy for metastatic MCC.
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