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Clinical remission of Merkel cell carcinoma after treatment with imatinib

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    Since these patients are not candidates for surgical intervention, their options are limited to standard chemotherapy regimens which have only palliative benefit. Furthermore, targeted therapy, such as those against Bcl-2, PI3K/AKT, and tyrosine kinases, has failed in clinical trials [5] despite success in preclinical studies and individual clinical case reports [6–9]. Therapies inhibiting the bromodomain and extra terminal (BET) family of proteins, Brd2, Brd3, and Brd4, have shown promise in preclinical and early phase clinical studies [10–12].

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    Therefore, the decision to provide adjuvant or palliative treatment of this type, particularly in older or immunocompromised patients, should be grounded in the clinical judgement of a multidisciplinary team. Surprisingly good outcomes have been reported in isolated cases of MCC treated with c-kit inhibitors in recent years.73 Although CD117 expression was detected by immunohistochemistry in 95% of MCC tumors in one series, mutations on the c-kit receptor could not be demonstrated.74

  • Merkel cell carcinoma: Epidemiology, prognosis, therapy and unmet medical needs

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    Although tumour suppressors and oncogenes are not commonly mutated in MCC, several receptor kinases and/or ligands are expressed, such as PI3K/Akt, c-kit, VEGFA, VEGFC, VEGFR-2, PDGF-α and PDGF-β [99,159–161]. In a case report, one patient had a complete response following treatment with the tyrosine kinase inhibitor imatinib [162], although a phase 2 clinical trial of imatinib was discontinued prematurely after no further evidence of efficacy was reported [163]. A clinical trial of cabozantinib, a c-met and VEGFR-2 inhibitor, in patients with recurrent/metastatic MCC, is ongoing (NCT02036476).

  • Dramatic response of an inoperable Merkel cell carcinoma with imatinib

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    However, the study was terminated early because of an excessive progression rate.7 Moreover, 2 isolated cases of inoperable Merkel cell tumor treated with imatinib were reported in the literature.8,9 One of the cases was a 92-year-old woman who had an MCC of the cheek.

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Funding sources: None.

Conflicts of interest: None declared.

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