Clinical characteristics and treatments of Merkel cell carcinoma in Japan: A multi-center retrospective study

<h2>Abstract</h2><h3>Background</h3> Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous neuroendocrine carcinoma with limited data from Asian populations. <h3>Material and methods</h3> We retrospectively analyzed data from 216 patients with stage I–III MCC who received surgery or radiotherapy, and 76 patients at any stage who received systemic therapy, across 36 Japanese institutions between April 2018 and March 2022. <h3>Results</h3> The cohort demonstrated a higher incidence in females and a high rate of Merkel cell polyomavirus (MCPyV) positivity. Among stage I–III patients, 103 underwent surgery alone, 83 were treated with surgery and adjuvant radiotherapy, and 30 received radiotherapy alone. The 1-year recurrence-free survival (RFS) and overall survival (OS) rates were 73.7% and 90.7%, respectively. Although radiotherapy alone correlated with worse RFS and OS, no significant differences were observed among stage I–II patients treated with curative-intent surgery, surgery plus adjuvant radiotherapy, or radiotherapy alone. Among 76 patients with unresectable or metastatic MCC who received systemic therapy, 72 received first-line avelumab; with a 43.1% response rate (RR), a median progression-free survival (PFS) of 9.9 months, and a median OS of 38.7 months. After avelumab failure, second-line chemotherapy yield a 46.2% RR and a median PFS of 4.1 months. <h3>Conclusion</h3> Japanese patients with MCC exhibited distinct clinical characteristics compared to Western populations, with comparable avelumab effectiveness. Outcomes did not differ significantly across modalities in patients with localized disease treated with curative intent. This largest real-world Asian MCC dataset provides key insights for optimizing treatment strategies for Asian patients.

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Journal
EJC Skin Cancer
Published
2025-01-01
DOI
https://doi.org/10.1016/j.ejcskn.2025.100755
Primary Topic
Polyomavirus and related diseases
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article
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article

Clinical characteristics and treatments of Merkel cell carcinoma in Japan: A multi-center retrospective study

Naoya Yamazaki, Toshikazu Omodaka, Shigeto Matsushita, Takeo Maekawa et al.
EJC Skin Cancer
Polyomavirus and related diseases
article

Clinical characteristics and treatments of Merkel cell carcinoma in Japan: A multi-center retrospective study

Naoya Yamazaki, Toshikazu Omodaka, Shigeto Matsushita, Takeo Maekawa, Naohito Hatta, Yasuhiro Fujisawa, Takuya Miyagawa, Kohei Oashi, Susumu Fujiwara, Taku Fujimura, Takeru Funakoshi, Osamu Yamasaki, Ko Kagoyama, S. Mori, Akiko Maruyama, Taku Maeda, Takamichi Ito, Kohei Yamakawa, Hiroaki Iwata, Eiji Nakano, Kenjiro Namikawa, Akira Kaneko, Junji Kato, Hiroshi Kitagawa, Shuichi Ohe, Teruki Yanagi, Takayuki Suyama, Kenta Nakama, Aya Nishizawa, Tatsuya Takenouchi, Shoichiro Ishizuki, Yuki Yamamoto, Dai Ogata, Wataru Omata, Tomoe Nakagawa, Shusuke Kawashima, Motoki Nakamura, Toshihiko Hoashi, Yasuhiro Nakamura
article en

Abstract

<h2>Abstract</h2><h3>Background</h3> Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous neuroendocrine carcinoma with limited data from Asian populations. <h3>Material and methods</h3> We retrospectively analyzed data from 216 patients with stage I–III MCC who received surgery or radiotherapy, and 76 patients at any stage who received systemic therapy, across 36 Japanese institutions between April 2018 and March 2022. <h3>Results</h3> The cohort demonstrated a higher incidence in females and a high rate of Merkel cell polyomavirus (MCPyV) positivity. Among stage I–III patients, 103 underwent surgery alone, 83 were treated with surgery and adjuvant radiotherapy, and 30 received radiotherapy alone. The 1-year recurrence-free survival (RFS) and overall survival (OS) rates were 73.7% and 90.7%, respectively. Although radiotherapy alone correlated with worse RFS and OS, no significant differences were observed among stage I–II patients treated with curative-intent surgery, surgery plus adjuvant radiotherapy, or radiotherapy alone. Among 76 patients with unresectable or metastatic MCC who received systemic therapy, 72 received first-line avelumab; with a 43.1% response rate (RR), a median progression-free survival (PFS) of 9.9 months, and a median OS of 38.7 months. After avelumab failure, second-line chemotherapy yield a 46.2% RR and a median PFS of 4.1 months. <h3>Conclusion</h3> Japanese patients with MCC exhibited distinct clinical characteristics compared to Western populations, with comparable avelumab effectiveness. Outcomes did not differ significantly across modalities in patients with localized disease treated with curative intent. This largest real-world Asian MCC dataset provides key insights for optimizing treatment strategies for Asian patients.

EJC Skin CancerVol. 3
Kurume University (JP), Kyushu University (JP), Shinshu University (JP), Sapporo Medical University (JP), University of Tsukuba (JP), Jichi Medical University (JP), Asahikawa Medical University (JP), Tokyo Medical University (JP), Chiba University (JP), Shimane University (JP), Kyoto Prefectural University (JP), Mie University (JP), Wakayama Medical University (JP), Tohoku University (JP), Keio University (JP), Hokkaido University (JP), Tokyo Metropolitan Komagome Hospital (JP), Nagoya City University (JP), Kyoto Prefectural University of Medicine (JP), Toyama Prefectural Central Hospital (JP), Shizuoka Cancer Center (JP), Niigata Cancer Center Hospital (JP), Tohoku University Hospital (JP), Osaka International Cancer Institute (JP), University of Tokyo Hospital (JP), Nagoya City University Hospital (JP), Saitama Cancer Center (JP), Shinshu University Hospital (JP), Saitama International Medical Center (JP), Kagoshima Medical Center (JP), Jichi Medical University Hospital (JP), Nippon Medical School Hospital (JP), Gifu University (JP), University of Toyama (JP), Ehime University (JP), Nagoya University (JP), Kobe University (JP), Dokkyo Medical University (JP), Nippon Medical School (JP), Saitama Medical University (JP), Yokohama City University (JP), Kumamoto University (JP)
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Polyomavirus and related diseases
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