Dr. Kudchadkar on Immunotherapy in Merkel Cell Carcinoma

Ragini Kudchadkar, MD

Ragini Kudchadkar, MD, assistant professor, Department of Hematology and Medical Oncology, associate director, Hematology and Medical Oncology Fellowship Program-Clinical/Service, Emory University School of Medicine, Winship Cancer Institute, discusses immunotherapy in Merkel cell carcinoma.

Merkel cell carcinoma has traditionally been treated with chemotherapy, says Kudchadker. The discovery of Merkel cell polyomavirus led to the development of immunotherapy, as it allows for clinicians to see PD-L1 staining and exhausted T cells.

Pembrolizumab (Keytruda), nivolumab (Opdivo), and avelumab (Bavencio) are all used for the treatment of Merkel cell carcinoma, and are demonstrating durable responses previously unseen in this disease.

Avelumab was approved by the FDA in March 2017 based on the data from the phase II JAVELIN Merkel 200 study. In the open-label trial, the objective response rate (ORR) with avelumab was 33% (95% CI, 23.3%-43.8%), which included an 11.4% (95% CI, 6.6%-19.9%) complete response rate and a 21.6% (95% CI, 13.5%-31.7%) partial response rate. 

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