Profound ctDNA and radiological responses after 2 cycles of avelumab in a metastatic Merkel cell carcinoma of the head and neck.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: England NLM ID: 9709118 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0593 (Electronic) Linking ISSN: 13688375 NLM ISO Abbreviation: Oral Oncol Subsets: MEDLINE
    • Publication Information:
      Publication: Amsterdam : Elsevier
      Original Publication: Oxford ; New York : Pergamon, c1997-
    • Subject Terms:
      Carcinoma, Merkel Cell*/drug therapy ; Antibodies, Monoclonal, Humanized*/therapeutic use ; Antibodies, Monoclonal, Humanized*/pharmacology ; Head and Neck Neoplasms*/drug therapy ; Head and Neck Neoplasms*/genetics ; Head and Neck Neoplasms*/pathology ; Skin Neoplasms*/drug therapy ; Skin Neoplasms*/pathology ; Skin Neoplasms*/genetics ; Circulating Tumor DNA*/genetics ; Circulating Tumor DNA*/blood; Humans ; Male ; Aged, 80 and over ; Antineoplastic Agents, Immunological/therapeutic use ; Antineoplastic Agents, Immunological/pharmacology
    • Abstract:
      Background: Merkel cell carcinoma (MCC) is an uncommon skin cancer that in more than 90 % of cases develops within the head and neck region. MCC is an aggressive disease with a dismal prognosis before the advent of immunotherapy. Avelumab, an anti-PDL1 agent is approved since 2017 for the treatment of advanced MCC after demonstrating a high response rate and favorable impact in survival.
      Methods: Next generation sequencing (NGS) of the primary tumor biopsy from initial diagnosis (Foundation One CDx, Roche Diagnostics) as well as from plasma samples (Foundation One Liquid, Roche Diagnostics) obtained before and during treatment with avelumab were performed.
      Results: We present the case of a patient with a metastatic MCC developing in the left parotid gland / pre-auricular area in an 80-year-old male with a long-lasting history of high UV exposure. After two cycles of avelumab 10 mg/kg/q2wk a near complete metabolic response and a major radiological response occurred in parallel to a brisk reduction in the ctDNA tumor fraction as well as variant-allele frequencies (VAFs) of all the mutations detected before the start of avelumab.
      Conclusion: Avelumab may achieve rapid and major responses in metastatic MCC. Our study demonstrates that ctDNA mirrors radiological responses and may serve as an ideal companion for diagnosis and disease monitoring in MCC.
      Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Santiago Cabezas-Camarero: Consultant for: Merck KgGa, GSK. Speaker’s Bureau for: BMS, Merck KgGa, MSD. Grant/Research support from (Clinical Trials): Astra Zeneca, Macrogenics, Sanofi, Merck KgGa. Travel and Academic work Fees from: Merck KgGa, BMS, Janssen, MSD. The rest of the authors declare no conflicts of interest relevant to the publication of this article.
      (Copyright © 2024 Elsevier Ltd. All rights reserved.)
    • Contributed Indexing:
      Keywords: Avelumab; Head and neck cancer; Liquid biopsy; Merkel cell carcinoma; ctDNA
    • Accession Number:
      0 (Antibodies, Monoclonal, Humanized)
      KXG2PJ551I (avelumab)
      0 (Circulating Tumor DNA)
      0 (Antineoplastic Agents, Immunological)
    • Publication Date:
      Date Created: 20240727 Date Completed: 20240820 Latest Revision: 20240820
    • Publication Date:
      20240821
    • Accession Number:
      10.1016/j.oraloncology.2024.106971
    • Accession Number:
      39067262