Merkel cell carcinoma: From pathobiology to clinical management

Peerzada Umar Farooq Baba, Zubaida Rasool, Ishrat Younas Khan, Clay J. Cockerell, Richard Wang, Martin Kassir, Henner Stege, Stephan Grabbe, Mohamad Goldust

Research output: Contribution to journalReview articlepeer-review

Abstract

Merkel cell carcinoma (MCC) is an infrequent, rapidly growing skin neoplasm that carries a greater probability of regional lymph node involvement, and a grim prognosis in advanced cases. While it is seen predominantly in old age in sun-exposed body parts, the prevalence varies among different races and geographical regions. Merkel cell polyomavirus and UV radiation-induced mutations contribute to its etiopathogenesis. The clinical presentation of MCC lacks pathognomonic features and is rarely considered highly at the time of presentation. Histopathological examination frequently reveals hyperchromatic nuclei with high mitotic activity, but immunohistochemistry is required to confirm the diagnosis. Sentinel lymph node biopsy (SLNB) and imaging are advised for effective staging of the disease. Multimodal management including surgery, radiation therapy, and/or immunotherapy are deployed. Traditional cytotoxic chemotherapies may result in an initial response, but do not result in a significant survival benefit. Checkpoint inhibitors have dramatically improved the prognosis of patients with metastatic MCC, and are recommended first-line in advanced cases. There is a need for well-tolerated agents with good safety profiles in patients who have failed immunotherapies.

Original languageEnglish (US)
Article number1293
JournalBiology
Volume10
Issue number12
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • Merkel cell carcinoma
  • Polyomavirus
  • Sentinel lymph node
  • UV-radiation

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Agricultural and Biological Sciences(all)

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