Single administration of avelumab induced a complete response in thyroid transcription factor-1 positive combined Merkel cell carcinoma
Single administration of avelumab induced a complete response in thyroid transcription factor-1 positive combined Merkel cell carcinoma
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单次施用 avelumab 可诱导甲状腺转录因子 1 阳性合并默克尔细胞癌完全缓解
DOI：
10.1111/1346-8138.15543
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Hironobu Ihn
中科院分区：
文献类型：
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作者：
Hisashi Kanemaru;Satoshi Fukushima;Yukari Mizukami;Soichiro Sawamura;Kayo Nakamura;Noritoshi Honda;Katsunari Makino;Ikko Kajihara;Jun Aoi;Takamitsu Makino;Takeshi Kawasaki;Erina Kudou;Masayoshi Jhono;Takaaki Ito;Nobuyuki Arima;Hironobu Ihn
默克尔细胞癌（MCC）是一种侵袭性肿瘤，发生转移的患者生存结果较差。最近，avelumab 是一种抗程序性死亡配体 1 (PD-L1) 免疫检查点抑制剂，被批准用于转移性 MCC 患者的一线治疗。虽然 avelumab 的给药间隔是每两周一次，但单次给药的持久效果尚不清楚。此外，avelumab 对纯 MCC 或合并非 MCC 组织学的 MCC 的影响尚未完全阐明。在此，我们报告一例合并MCC并发鳞状细胞癌的病例；患者在单次服用 avelumab 后获得完全缓解。尽管 avelumab 的水平在 12 周内超出了检测限，但在给药后 28 周以上仍保持显着疗效。免疫组化分析显示，该患者原发肿瘤病灶中PD-L1和默克尔细胞多瘤病毒大T抗原表达几乎阴性或仅部分阴性。相反，甲状腺转录因子1（TTF-1）在原发性MCC病灶中表达呈阳性，这与之前的报道一致，即合并MCC中TTF-1表达呈阳性。总之，本案例研究呈现了一个罕见的 TTF-1 阳性合并 MCC 病例，在单次给予 avelumab 后显示出完全缓解。
Merkel cell carcinoma (MCC) is an aggressive neoplasm and patients with metastasis have poor survival outcomes. Recently, avelumab, an anti‐programmed death ligand 1 (PD‐L1) immune checkpoint inhibitor, was approved for first‐line treatment in patients with metastatic MCC. While the administration interval of avelumab is every 2 weeks, the durable effect of a single administration of avelumab is unknown. Additionally, the effect of avelumab in pure MCC or combined MCC concurrent with non‐MCC histology has not been fully elucidated. Herein, we report a case of combined MCC concurrent with squamous cell carcinoma; the patient had a complete response after a single administration of avelumab. Although the levels of avelumab were outside the detection limit within 12 weeks, a remarkable efficacy remained for more than 28 weeks after administration. Immunohistochemical analyses revealed that the expression of PD‐L1 and Merkel cell polyomavirus large T antigen was almost negative or only partial in the primary tumor lesion of this patient. Conversely, thyroid transcription factor 1 (TTF‐1) expression was positive in the primary MCC lesion, which is consistent with a previous report that combined MCC is positive for TTF‐1 expression. In conclusion, this case study presents a rare case of TTF‐1‐positive combined MCC showing complete response after a single administration of avelumab.