Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysis
Abstract Background Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer characterized by high rates of metastasis. Emerging evidence suggests that PD-L1/PD1 blockade holds promise as a therapeutic option for MCC. However, the efficacy and safety of this approach in treati...
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BMC
2024-11-01
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| Online Access: | https://doi.org/10.1186/s12885-024-13129-1 |
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| author | Francisco Cezar Aquino de Moraes Michele Kreuz Isabella Christina Amaral de Lara Artur de Oliveira Macena Lôbo Rommel Mario Rodríguez Burbano |
| author_facet | Francisco Cezar Aquino de Moraes Michele Kreuz Isabella Christina Amaral de Lara Artur de Oliveira Macena Lôbo Rommel Mario Rodríguez Burbano |
| author_sort | Francisco Cezar Aquino de Moraes |
| collection | DOAJ |
| description | Abstract Background Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer characterized by high rates of metastasis. Emerging evidence suggests that PD-L1/PD1 blockade holds promise as a therapeutic option for MCC. However, the efficacy and safety of this approach in treating MCC remain incompletely understood. This systematic review and meta-analysis aims to analyze the efficacy and safety of PD-1/PD-L1 blockade for patients with MCC. Methods PubMed, Cochrane, and Embase were searched for studies evaluating patients with MCC undergoing PD-1/PD-L1 treatment. The estimated outcomes were overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs). We performed the meta-analysis using RStudio v4.4.2 software. Results A total of 14 reports of 13 different studies encompassing 615 patients were included. The median age ranged from 64 to 77 years. Median follow-up ranged from 7.9 months to 59.3 months. Pooled OS rates at 24 and 36 months were 65.05% (95% CI 44.04–81.49) and 59.58% (95% CI 39.62–76.81), respectively, while pooled PFS rates at 6, 12, and 36 months were 51.78% (95% CI 37.83–65.45), 46.12% (95% CI 29.44–63.72), and 28.73% (95% CI 16.57–45.02), in the same order. DCR proportion was 61.65% (95% CI 54.85–68.03) and ORR was 53.79% (95% CI 47.80-59.68). The frequency of TRAEs of any grade was 61.72% (95% CI 45.75–75.51) and for TRAEs of grade ≥ 3 was 17.60% (95% CI 12.28 to 24.57). Conclusions This systematic review and meta-analysis revealed that patients with MCC undergoing treatment with PD-1/PDL-1 showed durable responses with continuous and clinically meaningful survival outcomes. Graphical Abstract |
| format | Article |
| id | doaj-art-aa2f348fe8c44e6cbce23690edd53adb |
| institution | OA Journals |
| issn | 1471-2407 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-aa2f348fe8c44e6cbce23690edd53adb2025-08-20T02:13:28ZengBMCBMC Cancer1471-24072024-11-0124111310.1186/s12885-024-13129-1Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysisFrancisco Cezar Aquino de Moraes0Michele Kreuz1Isabella Christina Amaral de Lara2Artur de Oliveira Macena Lôbo3Rommel Mario Rodríguez Burbano4Federal University of ParáLutheran University of BrazilCesumar UniversityFederal University Of PernambucoFederal University of ParáAbstract Background Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer characterized by high rates of metastasis. Emerging evidence suggests that PD-L1/PD1 blockade holds promise as a therapeutic option for MCC. However, the efficacy and safety of this approach in treating MCC remain incompletely understood. This systematic review and meta-analysis aims to analyze the efficacy and safety of PD-1/PD-L1 blockade for patients with MCC. Methods PubMed, Cochrane, and Embase were searched for studies evaluating patients with MCC undergoing PD-1/PD-L1 treatment. The estimated outcomes were overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs). We performed the meta-analysis using RStudio v4.4.2 software. Results A total of 14 reports of 13 different studies encompassing 615 patients were included. The median age ranged from 64 to 77 years. Median follow-up ranged from 7.9 months to 59.3 months. Pooled OS rates at 24 and 36 months were 65.05% (95% CI 44.04–81.49) and 59.58% (95% CI 39.62–76.81), respectively, while pooled PFS rates at 6, 12, and 36 months were 51.78% (95% CI 37.83–65.45), 46.12% (95% CI 29.44–63.72), and 28.73% (95% CI 16.57–45.02), in the same order. DCR proportion was 61.65% (95% CI 54.85–68.03) and ORR was 53.79% (95% CI 47.80-59.68). The frequency of TRAEs of any grade was 61.72% (95% CI 45.75–75.51) and for TRAEs of grade ≥ 3 was 17.60% (95% CI 12.28 to 24.57). Conclusions This systematic review and meta-analysis revealed that patients with MCC undergoing treatment with PD-1/PDL-1 showed durable responses with continuous and clinically meaningful survival outcomes. Graphical Abstracthttps://doi.org/10.1186/s12885-024-13129-1Merkel cell carcinomaSkin cancerPD-1/PD-L1 inhibitorsMeta-analysis |
| spellingShingle | Francisco Cezar Aquino de Moraes Michele Kreuz Isabella Christina Amaral de Lara Artur de Oliveira Macena Lôbo Rommel Mario Rodríguez Burbano Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysis BMC Cancer Merkel cell carcinoma Skin cancer PD-1/PD-L1 inhibitors Meta-analysis |
| title | Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysis |
| title_full | Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysis |
| title_fullStr | Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysis |
| title_full_unstemmed | Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysis |
| title_short | Efficacy and safety of PD-1/PD-L1 inhibitors in patients with Merkel Cell Carcinoma: a systematic review and Meta-analysis |
| title_sort | efficacy and safety of pd 1 pd l1 inhibitors in patients with merkel cell carcinoma a systematic review and meta analysis |
| topic | Merkel cell carcinoma Skin cancer PD-1/PD-L1 inhibitors Meta-analysis |
| url | https://doi.org/10.1186/s12885-024-13129-1 |
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