About Merkel Cell Carcinoma
Merkel cell carcinoma is a rare but highly aggressive primary cutaneous neuroendocrine carcinoma with two distinct molecular aetiologies: integration of Merkel cell polyomavirus (MCPyV) DNA into the host genome, accounting for approximately 80% of cases in immunocompetent patients in low-UV climates, and UV-induced somatic mutational burden in virus-negative tumours. MCC carries a disease-specific mortality of approximately 33% and a high propensity for regional lymph node and distant metastasis; however, the tumour is exquisitely immunogenic, making it one of the most responsive solid tumours to immune checkpoint inhibitors. Immunosuppression — whether from organ transplant, HIV, or haematological malignancy — dramatically increases incidence and worsens outcomes.
Common Clinical Features
Clinical Trial Eligibility Tips
What to know before applying to Merkel Cell Carcinoma trials.
MCPyV serology (Merkel cell polyomavirus antibody titre) and tumour MCPyV status by IHC or PCR are increasingly used as eligibility or stratification factors — obtain this data from the pathology report or arrange testing.
Immunosuppression management is critical: transplant patients may need immunosuppression reduction before or during checkpoint inhibitor trials, requiring co-ordination with transplant medicine.
PD-L1 expression testing and tumour mutational burden (TMB) may be required for some checkpoint inhibitor combination trials; ensure comprehensive molecular profiling is available.
Patient Resources
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