The treatment of Merkel cell carcinoma with immune checkpoint inhibitors: Implications for patients with rheumatoid arthritis

Gina Klee, Tobias Kisch, Christiane Kümpers, Sven Perner, Susanne Schinke, Detlef Zillikens, Ewan A. Langan*, Patrick Terheyden

*Korrespondierende/r Autor/-in für diese Arbeit

Abstract

Objectives: Merkel cell carcinoma (MCC) is a rare, highly aggressive neuroendocrine skin cancer, which typically affects elderly and immunocompromised and/or immunosuppressed patients. The checkpoint inhibitor avelumab, a mAb targeting the anti-programmed cell death ligand 1 (anti-PD-L1), has revolutionized the treatment of metastatic MCC, achieving dramatic improvements in disease control and overall survival. However, checkpoint inhibitors are associated with the development of immune-related adverse events, such as exacerbation of pre-existing RA. Although most immune-related adverse events can be managed successfully with CSs, their frequent and/or long-term use runs the risk of undermining the efficacy of immune checkpoint inhibition. Methods: We report two cases of MCC, in which immunosuppressive therapy for the management of RA was administered. Results: Immunosuppression for (i) pre-existing and (ii) immune checkpoint inhibitor-exacerbated RA was associated with progression of metastatic MCC. Conclusion: Any decision to initiate immunosuppressive treatment for RA in patients receiving immune checkpoint inhibitor therapy should include careful consideration of the risk of potentially fatal cancer progression and be taken after consultation with the patient's oncologist and rheumatologist. When the immunosuppressive treatment is required, it should be administered for as short a time as possible and under strict clinical and radiological surveillance.

OriginalspracheEnglisch
Aufsatznummerrkab037
ZeitschriftRheumatology Advances in Practice
Jahrgang5
Ausgabenummer3
DOIs
PublikationsstatusVeröffentlicht - 2021

Strategische Forschungsbereiche und Zentren

  • Forschungsschwerpunkt: Infektion und Entzündung - Zentrum für Infektions- und Entzündungsforschung Lübeck (ZIEL)

Fingerprint

Untersuchen Sie die Forschungsthemen von „The treatment of Merkel cell carcinoma with immune checkpoint inhibitors: Implications for patients with rheumatoid arthritis“. Zusammen bilden sie einen einzigartigen Fingerprint.

Zitieren