A recent clinical trial led by NYU Langone Health and its Perlmutter Cancer Center has shown that immunotherapy using pembrolizumab (Keytruda) after surgery may help prevent the spread of Merkel cell carcinoma, a rare and aggressive form of skin cancer. The study is the largest to date evaluating pembrolizumab for this condition following tumor removal.
The trial involved 293 patients whose Merkel cell carcinoma had either grown or spread. All participants underwent surgery to remove their tumors; 147 received pembrolizumab infusions post-surgery, while 146 did not. Patients were monitored to track cancer recurrence, with some also receiving radiation therapy as advised by their physicians.
After two years, 73 percent of those treated with pembrolizumab showed no signs of cancer recurrence, compared to 66 percent in the group that did not receive the drug. However, researchers noted that this difference was not statistically significant. A more notable finding was a significant improvement in distant metastasis-free survival among those who took pembrolizumab. These patients had a 42 percent lower risk of dying from their cancer spreading to organs such as bones, liver, or lungs.
“Our study provides the first solid evidence that immunotherapy with pembrolizumab postsurgery may help people with Merkel cell carcinoma by preventing their cancer from returning in organs considered distant from the site of the original disease,” said lead investigator Janice Mehnert, MD.
“This is a positive development for people who are living with the highly aggressive cancer that is Merkel cell carcinoma,” Dr. Mehnert added. She is director of the melanoma medical oncology program and associate director of clinical research at Perlmutter Cancer Center.
Dr. Mehnert presented these findings at the European Society for Medical Oncology meeting in Berlin on October 20. She highlighted that since Merkel cell carcinoma is classified as a rare tumor by the National Cancer Institute (NCI), national collaborations are essential for conducting large-scale trials.
Pembrolizumab works as a PD-1 inhibitor, blocking a mechanism that helps cancer cells evade detection by the immune system and enabling immune cells to attack them more effectively.
Merkel cell carcinoma affects no more than three in one million people annually and primarily appears as a bump on sun-exposed skin in individuals over age 50. The disease spreads quickly and fewer than half survive five years after diagnosis.
Funding for this study came from grants provided by the NIH and NCI’s National Clinical Trials Network.
Other institutions involved included Dana-Farber Cancer Institute, Cleveland Clinic, University of Arizona, Greater Baltimore Medical Center, Stanford University, Moffitt Cancer Center, Weill Cornell Medicine, and University of Pittsburgh Medical Center.
NYU Langone Health operates seven inpatient locations and over 320 outpatient sites across New York and Florida. It recently reported $15.5 billion in annual revenue and has been recognized nationally for quality care by organizations such as Vizient Inc. and U.S. News & World Report.
