Abstract

BackgroundPatients with metastatic Merkel cell carcinoma (mMCC) who experience disease progression on immunotherapy have limited additional standard options. Given evidence of synergism between radiation therapy (RT) and immunotherapy, two patients progressing on PD-1 inhibition were referred for short-course RT.Case presentationTwo patients were found to have progressive mMCC on PD-1 inhibitor therapy and were treated with single-fraction palliative RT. Both patients were observed to have local control at irradiated regions, as well as durable abscopal response at unirradiated, out-of-field, sites of metastatic disease.ConclusionsShort-course RT is a compelling strategy that could be a means to augment response in patients with mMCC who show progression on immune checkpoint blockade. Ongoing clinical trials are investigating the relationship between RT and immunotherapy in mMCC.

Highlights

  • Patients with metastatic Merkel cell carcinoma who experience disease progression on immunotherapy have limited additional standard options

  • Short-course radiation therapy (RT) is a compelling strategy that could be a means to augment response in patients with metastatic Merkel cell carcinoma (mMCC) who show progression on immune checkpoint blockade

  • Ongoing clinical trials are investigating the relationship between RT and immunotherapy in mMCC

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Summary

Conclusions

Short-course RT is a compelling strategy that could be a means to augment response in patients with mMCC who show progression on immune checkpoint blockade.

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