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Immunotherapy: Hope for Merkel cell carcinoma patients | Department of Medicine | University of Washington
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Immunotherapy: Hope for Merkel cell carcinoma patients
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April 19, 2016
Immunotherapy: Hope for Merkel cell carcinoma
patients
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RESEARCH
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Merkel cell carcinoma (MCC) is a rare, aggressive type of skin
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cancer. It is less common than melanoma, but patients are
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three times more likely to die from it. (http
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Dr. Paul Nghiem, head of the Division of Dermatology
(http
(/division/dermatology), is leading a clinical trial of an
immunotherapy drug, pembrolizumab, where just over half
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of patients with advanced cancers saw their tumor shrink or
(http
disappear after receiving the immune-boosting drug. Paul Nghiem looks at a sample of Merkel cell
Pembrolizumab acts by removing the “brakes” present on
Service.
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carcinoma. Photo courtesy Fred Hutch News
med
Staf
tumor-speci䕰c immune cells called T cells, thereby allowing
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4/28/2016
Immunotherapy: Hope for Merkel cell carcinoma patients | Department of Medicine | University of Washington
tumor-speci䕰c immune cells called T cells, thereby allowing
(http
the T cells to kill the cancer cells.
“We believe that the immune system is likely ‘seeing’ different targets in the virus-positive and
virus-negative patients,” Nghiem said. Nghiem explained that virus-positive tumors produce the viral proteins needed for the tumors to grow.
These viral proteins may be readily seen by the immune system. In contrast, virus-negative MCC has
extremely high numbers of mutations caused by sunlight. These mutations can change the normal cellular
proteins so they no longer appear as “self” and the immune system can then see and attack these tumors.
The study was conducted at eight sites nationwide through the Fred Hutch-based Cancer Immunotherapy
Trials Network (http://citninfo.org/), led by Dr. Mac Cheever in the Division of Medical Oncology
(/division/oncology-medical). “It’s quite remarkable that one agent that unleashes T cells that are already in the body can have
such a profound effect in many of the patients,” Cheever said. The results of the immunotherapy treatment also last longer on average than chemotherapy treatment. The
study is still ongoing, but the vast majority (86 percent) who responded to pembrolizumab are still
experiencing excellent disease control more than six months after starting therapy, according to Nghiem. Pembrolizumab is also tolerated better than chemotherapy, with few to no side e橔‾ects. "It's remarkable how
well-tolerated it is in most of the patients," said Dr. Shailender Bhatia, who is the Seattle site leader for the
clinical trial. Nghiem says there are currently no FDA-approved drugs for the treatment of Merkel cell carcinoma, but they
are expanding the trial to recruit additional patients and hope that these data will contribute to meaningful
new therapeutic options becoming available for these patients. The results of the study are published in this week's New England Journal of Medicine (http://bit.ly/1qCV7OQ). LATEST NEWS
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