Skin Cancer - Merkel Cell Carcinoma Medication

Updated: Jul 22, 2019
  • Author: James M Pearson, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Medication

Medication Summary

In 2017, avelumab became the first drug approved by the FDA for metastatic Merkel cell carcinoma in adults and children aged 12 years or older. It is a programmed death 1 (PD-1) inhibitor. [20] In 2018, another PD-1 inhibitor, pembrolizumab, was approved for adults and children with metastatic or recurrent, locally advanced Merkel cell carcinoma. [22, 21]

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

Programmed cell death-1 (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)

Anti-PD-L1 IgG1 monoclonal antibody. It is indicated for metastatic MCC in adults and pediatric patients aged 12 years or older.

Pembrolizumab (Keytruda)

Monoclonal antibody that targets PD-1. It blocks PD-1 from interacting with ligands PD-L1 and PD-L2. Indicated for adults and children with metastatic or recurrent, locally advanced Merkel cell carcinoma.

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