Improved survival at the population level for patients with advanced Merkel cell carcinoma following availability of immunotherapy

IF 11.8 1区医学 Q1 DERMATOLOGY Journal of the American Academy of Dermatology Pub Date : 2025-03-10 DOI:10.1016/j.jaad.2025.03.006

Kelly G. Paulson MD, PhD , Song Y. Park MD , Shailender Bhatia MD , Daniel S. Hippe MS , Paul Nghiem MD, PhD

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Abstract

Background

Merkel cell carcinoma (MCC) is an aggressive skin cancer with poor survival rates. Immune checkpoint inhibitors (ICIs) were Food and Drug Administration-approved for advanced MCC in 2017, but their real-world survival impact remains unclear.

Objective

Evaluate whether ICI introduction in the United States corresponded with improved survival.

Methods

This cohort study analyzed Surveillance, Epidemiology, and End Results data for MCC patients diagnosed from 2010 to 2021, grouped by 3-year periods, to calculate 2-year overall and relative survival.

Results

For 453 patients with metastatic MCC, 2-year relative survival improved from 23% (2010-2012) to 37% (2013-2015), 42% (2016-2018), and 54% (2019-2021) (P < .001). Median overall survival also increased from 9 to 16 months among these patients. In 4786 MCC patients overall, 2-year relative survival rose from 73% (2010-2012) to 81% (2019-2021) (P = .004), while overall survival improved from 67% to 72% (P = .012).

Limitations

Surveillance, Epidemiology, and End Results lacks case-level data to link ICI treatment directly to survival, although ICIs represent the major recent treatment advance for MCC.

Conclusions

The introduction of ICIs aligns with a >2-fold increase in survival for advanced MCC patients at the population level, translating to ∼220 fewer deaths per year in the United States

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免疫治疗改善了晚期默克尔细胞癌患者在人群水平上的生存率。

背景：默克尔细胞癌（MCC）是一种侵袭性皮肤癌，生存率低。免疫检查点抑制剂（ici）于2017年获得fda批准用于晚期MCC，但其实际生存影响尚不清楚。目的：评价在美国引入ICI是否能提高生存率。方法：本队列研究分析了2010年至2021年诊断的MCC患者的SEER数据，以3年为周期分组，计算2年的总生存率和相对生存率。结果：453例转移性MCC患者的2年相对生存率从23%（2010-2012年）提高到37%（2013-2015年）、42%（2016-2018年）和54%（2019-2021年）（p < 0.001）。这些患者的中位总生存期也从9个月增加到16个月。在4786例MCC患者中，2年相对生存率从73%（2010-2012年）上升到81%（2019-2021年）（p = 0.004），而总生存率从67%提高到72% （p = 0.012）。局限性：SEER缺乏将ICI治疗与生存率直接联系起来的病例级数据，尽管ICI代表了MCC最近的主要治疗进展。结论：在人群水平上，ICIs的引入使晚期MCC患者的生存率提高了2倍，在美国每年减少了220例死亡

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来源期刊

Journal of the American Academy of Dermatology 医学-皮肤病学

CiteScore

8.60

自引率

5.80%

发文量

2023

审稿时长

49 days

期刊介绍： The Journal of the American Academy of Dermatology (JAAD) is the official scientific publication of the American Academy of Dermatology (AAD). Its primary goal is to cater to the educational requirements of the dermatology community. Being the top journal in the field, JAAD publishes original articles that have undergone peer review. These articles primarily focus on clinical, investigative, and population-based studies related to dermatology. Another key area of emphasis is research on healthcare delivery and quality of care. JAAD also highlights high-quality, cost-effective, and innovative treatments within the field. In addition to this, the journal covers new diagnostic techniques and various other topics relevant to the prevention, diagnosis, and treatment of skin, hair, and nail disorders.