Dermatologic Manifestations of Merkel Cell Carcinoma Medication

Updated: Mar 24, 2023
  • Author: Meghana Agni, MD; Chief Editor: William D James, MD  more...
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Medication Summary

At this time, the US Food and Drug Administration (FDA) has approved several checkpoint inhibitor immunotherapies for the treatment of Merkel cell carcinoma, avelumab, pembrolizumab, and retifanlimab. Chemotherapy can be considered as a second-line, palliative option for patients with advanced, refractory disease (see Medical Care).


PD-1/PD-L1 Inhibitors

Class Summary

Programmed death receptor 1 (PD-1) and related target programmed death 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); EMD Serono/Pfizer

Avelumab is an IgG monoclonal antibody against PD-L1, which was approved by the FDA for treatment of advanced Merkel cell carcinoma on March 23, 2017. It is indicated for metastatic Merkel cell carcinoma in adults and pediatric patients aged 12 years or older.

Pembrolizumab (Keytruda); Merck

Pembrolizumab is an IgG monoclonal antibody against PD-1. It blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2. The FDA approved pembrolizumab for treatment of adults and children with recurrent, locally advanced, or metastatic Merkel cell carcinoma on December 19, 2018.

Retifanlimab (Zynyz)

Indicated for adults with metastatic or recurrent locally advanced Merkel cell carcinoma.