Rescue therapy for patients with anti-PD-1-refractory Merkel cell carcinoma: A multicenter, retrospective case series

Jaclyn Lopiccolo, Megan D. Schollenberger, Sumia Dakhil, Samuel Rosner, Osama Ali, William H. Sharfman, Ann W. Silk, Shailender Bhatia, Evan J. Lipson

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Merkel cell carcinoma (MCC) is a rare but clinically aggressive cancer with a high mortality rate. In recent years, antibodies blocking the interactions among PD-1 and its ligands have generated durable tumor regressions in patients with advanced MCC. However, there is a paucity of data regarding effective therapy for patients whose disease is refractory to PD-1 pathway blockade. This retrospective case series describes a heterogeneous group of patients treated with additional immune checkpoint blocking therapy after MCC progression through anti-PD-1. Among 13 patients treated with anti-CTLA-4, alone or in combination with anti-PD-1, objective responses were seen in 4 (31%). Additionally, one patient with MCC refractory to anti-PD-1 and anti-CTLA-4 experienced tumor regression with anti-PD-L1. Our report - the largest case series to date describing this patient population - provides evidence that sequentially-administered salvage immune checkpoint blocking therapy can potentially activate anti-tumor immunity in patients with advanced anti-PD-1-refractory MCC and provides a strong rationale for formally testing these agents in multicenter clinical trials. Additionally, to the best of our knowledge, our report is the first to demonstrate possible anti-tumor activity of second-line treatment with a PD-L1 antibody in a patient with anti-PD-1-refractory disease.

Original languageEnglish (US)
Article number170
JournalJournal for immunotherapy of cancer
Issue number1
StatePublished - Jul 8 2019


  • Anti-PD-1-refractory
  • Immune checkpoint blockers
  • Merkel cell carcinoma
  • Progression

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research


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