“…The tumour is typicallylocatedinskinregionsthatarechronicallyexposed tosun.Whenpresentonthetrunkorintheglutealregion,the tumour can appear as a deep subcutaneous skin-coloured cyst-like nodule [4], and this seemingly benign appearance candelaydiagnosisorincreasetheriskofinsufficienttumour patientswithregionallymphnodemetastases.Postoperative adjuvant chemotherapy at this stage of disease is usually indicated in high-risk patients -extensive lymph node involvement, extra-nodal expansion, and recurrence following previoustherapy [26,27].Thesecasescanalsobeextendedto includeradiotherapy [28].Mostexperiencehasbeenobtained from the use of protocols containing etoposide and carboplatinusedinthefirstlinetreatmentofsmall-celllungcarcinoma [29,27].Chemotherapyisthemainstayoftreatmentin stageIIIdiseaseandisoftencombinedwithpalliativeradiotherapy and surgical intervention when possible [22]. This treatmentisreportedtobeeffectivein60-75%ofcases,but themedianofsurvivalismeasuredinmonths [30].Therefore, therapeuticsuccessappearstodependonthedevelopmentof newtherapeuticmodalities.Inthisrespect,anumberofantibodiesagainstsurfacereceptorsoftheproteinkinasesignalling network [31,32] have been tested, as well as methods of inhibition of genes expressed in the tumour cells and responsibleforcellularproliferationandapoptosis,usingantisense oligonucleotides or microRNAs [33]. The anti-tumour effect of IFN-alpha [34] remains to be confirmed, as well as whetherAtonalhomolog1functionsasatumoursuppressor geneinMerkelcellsandthewaysinwhichitsregulationcould beutilisedforanti-cancertherapy [35].Inthefuture,prophylaxiswithvaccinationagainstMCPyVhopefullywillbepossibleinimmunosuppressedpatientswhohavenotbeenpreviouslyinfectedwithMCPyV [36].…”