Avelumab Treatment in Very Elderly People With Advanced Merkel Cell Carcinoma: A Case Report and Review of the Literature

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer, with a higher incidence in elderly and immunocompromised patients. Immunotherapy with anti-programmed death-ligand 1 (anti-PD-L1) agents, particularly avelumab, has revolutionized the treatment landscape of advanced MCC. However, evidence regarding its safety and efficacy in very elderly patients (aged ≥85 years) remains scarce. We report the case of a 95-year-old woman with locally advanced MCC treated with avelumab, achieving a major clinical response and maintaining disease control after treatment discontinuation. A literature review on immunotherapy in the very elderly MCC population is also provided.