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Durable Complete Response to First Line Treatment with Avelumab in an Elderly, Multimorbid Patient with Advanced Merkel Cell Carcinoma: A Case Report

Abstract

Enrico Sammarco*, Amedeo Nuzzo, Simona Manacorda, Fiorella Manfredi, Chiara Mercinelli, Marco Ferrari, Giulia Massaro, Adele Bonato, Alessia Salfi, Debora Serafin, Luca Zatteri Luca, Galli Andrea Antonuzzo and Gianluca Masi

Introduction: Metastatic Merkel Cell Carcinoma (MCC) is characterized by poor prognosis and poor response to cytotoxic chemotherapy. Immune Checkpoint Inhibitors (ICIs) were evaluated in several clinical trials, providing interesting results in terms of activity and efficacy, with a generally manageable safety profile. Limited data are available for use of ICIs in patients affected by multiple chronic diseases. We present the case of a patient with several comorbidities treated with Avelumab for advanced MCC, who developed a durable complete response.

Case description: A 78-year-old woman with several chronic diseases was treated with Avelumab for MCC with lung and subcutaneous metastases, developing radiological complete response after 5 cycles. Treatment was well tolerated and no severe adverse events were observed.

Conclusion: Our case shows that Avelumab is an active and safe treatment in multimorbid patients with advanced MCC. More consistent data from randomized clinical trials are needed to confirm these results in a large patient population presenting these special features.

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