Avelumab for the treatment of patients with Merkel cell carcinoma

Autor: K. V. Orlova, N. N. Petenko, V. V. Nazarova, L. V. Demidov
Jazyk: ruština
Rok vydání: 2020
Předmět:
Zdroj: Медицинский совет, Vol 0, Iss 9, Pp 94-100 (2020)
Druh dokumentu: article
ISSN: 2079-701X
2658-5790
DOI: 10.21518/2079-701X-2020-9-94-100
Popis: Merkel cell carcinoma is a rare and aggressive skin tumor that is difficult to treat even at early stages. Treatment approaches for advanced disease are limited and standard chemotherapy provides short-lived disease control in half of patients without significant impact on the overall survival. The new immunotherapy with anti-PD-1/PD-L1 inhibitors allows to improve clinical outcomes of this disease. Avelumab is a fully human IgG1 monoclonal anti- PD-L1 antibody that blocks the interaction between programmed cell death ligand 1 (PD-L1) on tumor cells and programmed cell death-1 receptor (PD-1) on T cells, thereby elimination immunosuppression in the tumor microenvironment. Avelumab provides disease control in 43,2% of the patients with metastatic/locally advanced unresectable Merkel cell carcinoma for the second and subsequent lines treatment with the objective response rate (ORR) 33%. The response was ongoing for ≥ 6 months in 86% of patient with median duration of response 40,5 months. Responses occurred irrespectively of PD-L1 expression and presence of polyomavirus in tumor cells (MCPyV), 3-year overall survival rate reached 32%. Avelumab is more effective for the first line of treatment, providing the disease control in 78,6% the patients with ORR 71,5% lasting for ≥ 6 months. Treatment is well tolerated for the first, second and subsequent lines, demonstrating the adequate safety profile. The most common adverse events were fatigue, diarrhea and nausea. There were 7 patients in Russia treated with avelumab for metastatic/locally advanced unresectable Merkel cell carcinoma.
Databáze: Directory of Open Access Journals
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