Dermatologic Manifestations of Merkel Cell Carcinoma Medication

Updated: Nov 07, 2018
  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD  more...
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Medication

Medication Summary

Avelumab is the first drug approved by the US Food and Drug Administration for Merkel cell carcinoma. It is a programmed death 1 (PD-1) inhibitor. Another PD-1 inhibitor, pembrolizumab, has already been used, with promising results.

Platinum-based chemotherapy regimens have been also been used, but clinical efficacy is limited and brief.

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PD-1/PD-L1 Inhibitors

Class Summary

PD-1 and related target PD-ligand 1 (PD-L1) are expressed on the surface of activated T cells under normal conditions. PD-L1/PD-1 interaction inhibits immune activation and reduces T-cell cytotoxic activity when bound.

This negative feedback loop is essential for maintaining normal immune responses and limits T-cell activity to protect normal cells during chronic inflammation.

Avelumab (Bavencio)

Avelumab is an anti-PD-L1 IgG1 monoclonal antibody. It is indicated for metastatic Merkel cell carcinoma in adults and pediatric patients aged 12 years or older.

Pembrolizumab (Keytruda)

Pembrolizumab is a monoclonal antibody to programmed cell death-1 protein (PD-1). It blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2.

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