First-line immunotherapy improves survival in metastatic MCC

First-line immunotherapy results in improved median overall survival (OS) in patients with advanced Merkel cell carcinoma (MCC), reports a study, noting a better performance than chemotherapy in the real-world setting.

The authors identified 759 MCC patients between 2015 and 2020 with stage IV disease and known status of first-line systemic therapy using the National Cancer Database. They identified the predictors of immunotherapy usage through univariable and multivariable analyses, as well as compared OS for patients treated with immunotherapy, chemotherapy, or no systemic therapies.

Of the patients, 329 received immunotherapy, 161 chemotherapy, and 269 no systemic therapy. High facility volume was found to be a significant predictor of first-line immunotherapy use (odds ratio, 1.99; p=0.017) after adjustments for demographic, clinical, and facility factors.

Median OS was 16.2 months among patients treated with immunotherapy, 12.3 months among those who received chemotherapy, and 8.7 months for those not treated with systemic therapy (p<0.001).

Finally, multivariate analysis revealed the association of first-line immunotherapy treatment (hazard ratio [HR], 0.79; p=0.041) and treatment at high-volume centres (HR, 0.58; p=0.004) with improved OS.

“Treatment at high-volume centres [correlated] with first-line immunotherapy utilization, suggesting that familiarity with this rare disease is important to achieving optimal outcomes for metastatic MCC,” the authors said.