The Role of Free Tissue Transfer in Merkel Cell Carcinoma of the Head and Neck

Londino, Aldo V.; Miles, Brett A.

doi:10.1155/2012/742303

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…One situation where surgery has utility is in the case of free tissue transfer reconstruction after microvascular anastomosis [30]. This approach has the advantage of allowing additional radiation therapy to anatomic areas that previously underwent significant irradiation.…”

Section: Treatmentmentioning

confidence: 99%

Emerging and Mechanism-Based Therapies for Recurrent or Metastatic Merkel Cell Carcinoma

Miller

Bhatia

Parvathaneni

et al. 2013

Curr. Treat. Options in Oncol.

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Opinion statement Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine skin cancer with a disease-specific mortality of approximately 40 %. The association of MCC with a recently discovered polyomavirus, combined with the increased incidence and mortality of MCC among immunocompromised patients, highlight the importance of the immune system in controlling this cancer. Initial management of MCC is summarized within the NCCN guidelines and in recently published reviews. The high rate of recurrent and metastatic disease progression in MCC, however, presents a major challenge in a cancer that lacks mechanism-based, disease-specific therapies. Traditional treatment approaches have focused on cytotoxic chemotherapy that, despite frequent initial efficacy, rarely provides durable responses and has high morbidity among the elderly. In addition, the immunosuppressive nature of chemotherapy is of concern when treating a virus-associated cancer for which survival is unusually tightly linked to immune function. With a median survival of 9.6 months after development of an initial metastasis (n=179, described herein), and no FDA-approved agents for this cancer, there is an urgent need for more effective treatments. We review diverse management options for patients with advanced MCC, with a focus on emerging and mechanism-based therapies, some of which specifically target persistently expressed viral antigens. These treatments include single-dose radiation and novel immunotherapies, some of which are in clinical trials. Due to their encouraging efficacy, low toxicity, and lack of immune suppression, these therapies may offer viable alternatives to traditional cytotoxic chemotherapy.

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Section: Treatmentmentioning

confidence: 99%

Emerging and Mechanism-Based Therapies for Recurrent or Metastatic Merkel Cell Carcinoma

Miller

Bhatia

Parvathaneni

et al. 2013

Curr. Treat. Options in Oncol.

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“…However, irrespective of the type of surgery, sentinel lymph node biopsy (SLNB) should be carried out before definitive local excision, which can alter lymphatic drainage. Moreover, reconstructive techniques, including flaps and skin grafts, should reduce extensive tissue movements in order to perform SLNB appropriately and avoid delay in aRT start [36,37].…”

Section: Surgerymentioning

confidence: 99%

Multimodal Strategy in Localized Merkel Cell Carcinoma: Where Are We and Where Are We Heading?

Ricco

Andrini

Siepe

et al. 2021

IJMS

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Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumor of the skin whose incidence is rising. Multimodal treatment is crucial in the non-metastatic, potentially curable setting. However, the optimal management of patients with non-metastatic MCC is still unclear. In addition, novel insights into tumor biology and newly developed treatments (e.g., immune checkpoint inhibitors) that dramatically improved outcomes in the advanced setting are being investigated in earlier stages with promising results. Nevertheless, the combination of new strategies with consolidated ones needs to be clarified. We reviewed available evidence supporting the current treatment recommendations of localized MCC with a focus on potentially ground-breaking future strategies. Advantages and disadvantages of the different treatment modalities, including surgery, radiotherapy, chemotherapy, and immunotherapy in the non-metastatic setting, are analyzed, as well as those of different treatment modalities (adjuvant as opposed to neoadjuvant). Lastly, we provide an outlook of remarkable ongoing studies and of promising agents and strategies in the treatment of patients with non-metastatic MCC.

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