Combination of peptide receptor radionuclide therapy and immune checkpoint inhibitor in metastatic Merkel cell carcinoma

Document Type : Case Report

Authors

1 Nuclear Medicine Center, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran

2 Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 UW Dermatology, UW Medical Center at Lake Union, Seattle, Washington, USA

4 Fred Hutchinson Cancer Center, Seattle, Washington, USA

5 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

A 78-year-old woman with metastatic Merkel cell carcinoma (mMCC) to the cervical and thoracoabdominal lymph nodes as well as cutaneous and subcutaneous lesions on the thighs and trunk was referred for peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTA-TATE. Prior to PRRT, the disease had progressed through four cycles of pembrolizumab. Symptomatic benefit and a stable radiographic response was achieved following two cycles of [177Lu]Lu-DOTA-TATE therapy (cumulative dose: 13.32 GBq) in combination with pembrolizumab. The patient could not receive further cycles due to complications from COVID-19 infection. PRRT in combination with immune checkpoint inhibitors is a promising therapeutic option for mMCC patients, refractory to conventional therapies.

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