What is the role of chemotherapy in the treatment of Merkel cell carcinoma (MCC), and which drugs are commonly used?

Updated: Jan 18, 2019
  • Author: Arjun S Joshi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Chemotherapy with radiation therapy is being used to treat locally advanced or recurrent disease. A study by Chen et al of 4815 patients with MCC of the head and neck indicated that postoperative adjuvant therapy with chemoradiotherapy offers greater improvement in the overall survival rate than does postoperative radiotherapy alone in patients with male sex, tumor size of at least 3 cm, and positive margins. [34]

Chemotherapy for MCC is based on previous experience with small-cell lung carcinoma, which is pathologically similar to MCC. Common regimens include cyclophosphamide, doxorubicin, vincristine or etoposide, and cisplatin. Partial response rates approach 75%, and complete response rates are observed in 40% of patients with locally recurrent or advanced disease. Chemotherapy appears to be more effective for patients with locally advanced disease (response rate, 69%) than for those with metastatic disease (response rate, 57%).


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