OnCo

Merkel cell carcinoma: lines of therapy

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4 standard-of-care settings across 4 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersFRα
Early / localised1·
Locally advanced1·
Advanced, first line1·
Third line and beyond·1

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersLocalised (stage I-II)Wide local excision with sentinel node biopsy; adjuvant radiotherapy to the primary site (and nodal basin if node-positive); adjuvant nivolumab supported by ADMEC-O in selected patients.91

Locally advanced

SubgroupSettingApproachProducts and trialsEvidence
All comersRegional nodal disease (stage III)Lymphadenectomy and/or nodal radiotherapy; neoadjuvant nivolumab (CheckMate 358) produced pathological complete responses in about half.91

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersMetastatic, first lineAvelumab, pembrolizumab or retifanlimab; ~50% response with most responses durable.98

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
FRαImmunotherapy-refractoryPlatinum-etoposide chemotherapy (brief responses), radiotherapy, clinical trials (ipilimumab-nivolumab, T-VEC, adoptive T cells).82

Regimens in the library

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.