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BRIEF RESEARCH REPORT article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1495004
This article is part of the Research Topic Immunology and Immunotherapy of Skin Cancer View all 8 articles

Re-exposition to Ipilimumab plus Nivolumab in metastatic Merkel cell carcinoma

Provisionally accepted
Valerie Glutsch Valerie Glutsch 1*Patrick Schummer Patrick Schummer 1Matthias Goebeler Matthias Goebeler 1Anja Gesierich Anja Gesierich 1Bastian Schilling Bastian Schilling 1,2
  • 1 Department of Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Würzburg, Germany
  • 2 Goethe University Frankfurt, University Hospital, Department of Dermatology, Frankfurt, Germany

The final, formatted version of the article will be published soon.

    Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive cutaneous malignancy. Immune checkpoint inhibition (ICI) with PD-(L)1 blockade has significantly improved treatment outcomes in metastatic disease. In patients with primary resistance to PD-(L)1 inhibition, a high overall response rate (ORR) of 50% to later-line ipilimumab plus nivolumab (IPI/NIVO) has been demonstrated. However, clinical data on patients with progression after an initial response to IPI/NIVO are still lacking.Methods: Clinical data of three metastatic MCC patients who were re-exposed to IPI/NIVO after progression were retrospectively evaluated.Results: Two of the three patients showed primary resistance to avelumab with progressive disease, while one patient showed complete response (according to RECIST V.1.1). All three patients received combined ICI with IPI/NIVO as subsequent therapy, resulting in an ORR of ~ 67%. However, all three patients progressed during follow-up and were re-exposed to IPI/NIVO. With a follow-up period ranging from 6.5 to 37.1 months, no PFS event has been detected. ORR for IPI/NIVO re-exposition was equal to that of initial IPI/NIVO treatment.In this retrospective follow-up analysis, we observed a response rate of 67% and longlasting responses after re-exposition to combined ICI in metastatic MCC patients with progression after initial response or disease control upon their first IPI/NIVO treatment. An important observation from this small analysis is that primary resistance to PD-L1 inhibition may result in a better response to IPI/NIVO.

    Keywords: Merkel cell carcinoma1, immunotherapy2, resistance3, relapse4, ipilimumab5, nivolumab6

    Received: 11 Sep 2024; Accepted: 19 Nov 2024.

    Copyright: © 2024 Glutsch, Schummer, Goebeler, Gesierich and Schilling. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Valerie Glutsch, Department of Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Würzburg, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.