Management Recommendations for Merkel Cell Carcinoma: A Danish Perspective
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Management Recommendations for Merkel Cell Carcinoma : A Danish Perspective. / Naseri, Simon; Steiniche, Torben; Ladekarl, Morten; Bønnelykke-Behrndtz, Marie Louise; Hölmich, Lisbet R.; Langer, Seppo W.; Venzo, Alessandro; Tabaksblat, Elizaveta; Klausen, Siri; Larsen, Mathilde Skaarup; Junker, Niels; Chakera, Annette H.
In: Cancers, Vol. 12, No. 3, 554, 03.2020.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Management Recommendations for Merkel Cell Carcinoma
T2 - A Danish Perspective
AU - Naseri, Simon
AU - Steiniche, Torben
AU - Ladekarl, Morten
AU - Bønnelykke-Behrndtz, Marie Louise
AU - Hölmich, Lisbet R.
AU - Langer, Seppo W.
AU - Venzo, Alessandro
AU - Tabaksblat, Elizaveta
AU - Klausen, Siri
AU - Larsen, Mathilde Skaarup
AU - Junker, Niels
AU - Chakera, Annette H.
PY - 2020/3
Y1 - 2020/3
N2 - Merkel cell carcinoma (MCC) is a rare malignant neuroendocrine carcinoma of the skin with a poor prognosis and an apparent increase in incidence. Due to its rarity, evidence-based guidelines are limited, and there is a lack of awareness among clinicians. This review constitutes the consensus management recommendations developed by the Danish MCC expert group and is based on a systematic literature search. Patients with localized disease are recommended surgical excision and adjuvant radiotherapy to the primary site; however, this may be omitted in patients with MCC with low risk features. Patients with regional lymph node involvement are recommended complete lymph node removal and adjuvant radiotherapy in case of extracapsular disease. Metastatic disease was traditionally treated with chemotherapy, however, recent clinical trials with immune therapy have been promising. Immune checkpoint inhibitors targeting the programmed cell death protein 1(PD-1)/programmed death-ligand 1(PD-L1) axis should therefore be strongly considered as first-line treatment for fit patients. A 5-year follow-up period is recommended involving clinical exam every 3 months for 2 years and every 6 months for the following 3 years and PET-CT one to two times a year or if clinically indicated. These national recommendations are intended to offer uniform patient treatment and hopefully improve prognosis.
AB - Merkel cell carcinoma (MCC) is a rare malignant neuroendocrine carcinoma of the skin with a poor prognosis and an apparent increase in incidence. Due to its rarity, evidence-based guidelines are limited, and there is a lack of awareness among clinicians. This review constitutes the consensus management recommendations developed by the Danish MCC expert group and is based on a systematic literature search. Patients with localized disease are recommended surgical excision and adjuvant radiotherapy to the primary site; however, this may be omitted in patients with MCC with low risk features. Patients with regional lymph node involvement are recommended complete lymph node removal and adjuvant radiotherapy in case of extracapsular disease. Metastatic disease was traditionally treated with chemotherapy, however, recent clinical trials with immune therapy have been promising. Immune checkpoint inhibitors targeting the programmed cell death protein 1(PD-1)/programmed death-ligand 1(PD-L1) axis should therefore be strongly considered as first-line treatment for fit patients. A 5-year follow-up period is recommended involving clinical exam every 3 months for 2 years and every 6 months for the following 3 years and PET-CT one to two times a year or if clinically indicated. These national recommendations are intended to offer uniform patient treatment and hopefully improve prognosis.
KW - Diagnosis
KW - Guideline
KW - Merkel cell carcinoma
KW - Review
KW - Treatment
U2 - 10.3390/cancers12030554
DO - 10.3390/cancers12030554
M3 - Review
C2 - 32121063
AN - SCOPUS:85081033884
VL - 12
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 3
M1 - 554
ER -
ID: 243337668