Would you consider adjuvant immunotherapy for a patient with high-risk Merkel cell carcinoma following definitive surgical resection and adjuvant radiation therapy?

Although there is no level 1 data supporting adjuvant RT in MCC, a relatively recent meta-analysis from an Italian group (Petrelli et al., PMID 31005218) showed that adjuvant RT is associated with a 75% reduction in local and locoregional relapses versus surgery alone, without a reduction in distant...

The ECOG-ACRIN EA6174 study evaluated adjuvant pembro for high-risk stage III MCC. It was closed to accrual in 11/2024, so we await the result of that study to inform the role of adjuvant IO. In the meantime, I agree that surgery followed by adjuvant XRT is the current standard of care, and it may b...

The STAMP study was read out recently at ESMO 2025 and was reported to be a statistically negative study. A lot of controversy came about the results due to revisions of accrual goals and imbalanced use of RT. Hence, it is a discussion with the patient at the end of the day. Adjuvant use of IO in MC...

Well, pending the results of EA6174, there is really no proven standard of care. Radiation is used because this is a tradition, not a proven standard of care. It has not been tested in a randomized study. We ran a pilot study of such patients, comparing nivolumab + radiation (4 patients) versus ipi1...