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What’s New in Merkel Cell Carcinoma Research?

Because Merkel cell carcinoma (MCC) is very rare, it's been hard to study it well. Most experts agree that treatment in a clinical trial should be considered for any type or stage of MCC. This way people can get the best treatment available now and may also get the treatments that are thought to be even better. The new and promising treatments discussed here are only available in clinical trials.

Causes of MCC

Researchers are learning more about the Merkel cell polyomavirus (MCV), which is found in most MCC tumors. It’s not yet clear exactly how damage from UV light, infection with MCV, and changes in the body’s immune system might interact to cause MCC, but this is an active area of research.

Prevention and early detection of MCC

Most skin cancers, including many MCCs, can be prevented. The best way to lower the number of skin cancers is to educate the public, especially parents, about skin cancer risk factors and warning signs. It’s important for health care professionals and skin cancer survivors to remind others about the dangers of too much UV exposure (both from the sun and from man-made sources like tanning beds) and about how easy it can be to protect your skin from UV rays.

MCC can often be found early, when small, hasn't spread, and is most likely to be cured. Monthly skin self-exams and awareness of the warning signs of MCCs and other skin cancers can be helpful in finding them early.

The American Academy of Dermatology (AAD) sponsors annual free skin cancer screenings throughout the country. Many local American Cancer Society offices work closely with AAD to provide volunteers for registration, coordination, and education efforts related to these free screenings. Look for information in your area about these screenings or call the American Academy of Dermatology for more information. 

Treatment

While early-stage MCCs often can be cured, more advanced MCCs tend to be much harder to treat. It’s been hard to study the best way to treat these cancers because they're so rare. But in recent years, doctors have begun to look at newer types of treatment for this disease.

Immunotherapy

This type of treatment helps the body’s immune system attack cancer cells more effectively. Doctors have been hopeful that this approach might be useful against MCC, especially because this cancer appears to be linked to infection with a virus (MCV). And in recent years, certain immunotherapy drugs have been approved for treating MCC. Still, researchers are looking for other drugs that work with the immune system in different ways. They're also looking for better ways to use the immunotherapies available today.

Autologous T cell therapy: In this approach, immune cells called T cells are removed from a person’s blood, taken to the lab, and exposed to parts of the Merkel cell polyomavirus and chemicals that help activate the T cells. The cells are then infused back into the person's body. The hope is that these reengineered cells will now seek out and attack MCC cells. This approach is still in early phases of testing.

Hormone-like drugs

MCC is a type of neuroendocrine tumor, which means its cells share features with cells that normally make hormones in the body. Doctors are testing whether drugs that affect hormone-making cells might be helpful against MCC. One example is lanreotide which is part of a group of drugs known as somatostatin analogs. Research testing these types of drugs against MCC is still in very early phases.

Targeted therapy

Newer drugs called targeted therapies may someday be shown to help treat MCC. Targeted therapies attack parts of cancer cells that make them different from normal cells. Each type of targeted therapy works differently, but they all alter the way a cancer cell grows, divides, repairs itself, or interacts with other cells. Targeted drugs are already used to treat many types of cancer, and many are now being studied for use against MCC.

Combining treatments

Studies are looking at treatment combinations that might work better against MCC that no longer responds to the usual treatments. New drug combos and new ways to use radiation with chemo and/or immunotherapy are active areas of research.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American Society of Clinical Oncology. Neuroendocrine Tumor: Latest Research. 11/2016. Accessed at www.cancer.net/cancer-types/neuroendocrine-tumor/latest-research on September 21, 2018.

Chan IS, Bhatia S, Kaufman HL, Lipson EJ. Immunotherapy for Merkel cell carcinoma: a turning point in patient care. J Immunother Cancer. 2018;6(1):23. 

Tello TL, Coggshall K, Yom SS, Yu SS. Merkel cell carcinoma: An update and review: Current and future therapy. J Am Acad Dermatol. 2018;78(3):445-454. 

Voelker R. Why Merkel Cell Cancer Is Garnering More Attention. JAMA. 2018;320(1):18-20.

Last Revised: October 9, 2018

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