Useful Information and Links

For Merkel cell carcinoma (MCC) patients, family members and physicians

Useful Information

Concise summary of the February 2007 MCC presentation by Dr. Nghiem at the American Academy of Dermatology in Washington, DC.
Click here to download the information on this website.
MCC chapter from the 7th edition of Fitzpatrick's Dermatology in General Medicine written by Drs. Nghiem and Jaimes.
Kelly Garneski and Dr. Nghiem's adjuvant therapy paper [PDF], which was published in the Journal of the American Academy of Dermatology.
Short review of the biology of MCC from the Journal of Investigative Dermatology written by Drs. Lemos and Nghiem.

Useful Links

Support group for MCC patients and their families
NCCN Clinical Practice Guidelines in Oncology: Merkel cell carcinoma
MCC information for patients from the National Cancer Institute
MCC information for health professionals from the National Cancer Institute
MCC: Questions and Answers from the National Cancer Institute
Clinical trials in MCC
MCC Google Group FAQ for New Members

References:

Overviews of MCC

1. Agelli M, Clegg LX. Epidemiology of primary Merkel cell carcinoma in the United States. Journal of the American Academy of Dermatology 2003; 49:832-41.: National Cancer Institute epidemiologic study of 1,034 patients with MCC that found 1) a higher incidence of MCC in whites, males and patients older than 65 years, 2) that roughly half of all cases were localized, 3) better survival was associated with limb localization, early stage disease, younger age and female sex. This study does not contain data on what treatments patients received.

2. Bichakjian CK, Lowe L, Lao CD, Sandler HM, Bradford CR, Johnson TM, Wong SL. Merkel cell carcinoma: Critical review with guidelines for multidisciplinary management. Cancer 2007; 110:1-12.

Comprehensive reference for MCC treatment based on critical evaluation of the current available data.

3. Goessling W, McKee PH, Mayer RJ. Merkel cell carcinoma. Journal of Clinical Oncology 2002; 20:588-598. Click here for a PDF.: Comprehensive review of MCC based on the oncology literature.

4. Nghiem P, Jaimes N. Chapter 120: Merkel cell carcinoma. In Wolff K, Katz S, Goldsmith L, Gilchrest B, Leffell D, Paller A (eds), Fitzpatrick's Dermatology in General Medicine; 7th Edition. New York, NY: McGraw-Hill, 2007. Click here for a PDF.: Chapter thoroughly explaining what is currently known about MCC.

5. Nghiem P, McKee PH, Haynes HA. Merkel cell (cutaneous neuroendocrine) carcinoma. In Sober AJ, Haluska FG (eds): American Cancer Society Atlas of Clinical Oncology: Skin Cancer. Hamilton, Ontario: BC Decker Inc, 2001, pp 127-141. Click here for a PDF.: Comprehensive chapter on MCC in a multi authored atlas of skin cancer.

Immune Suppression and MCC

1. Engles EA, Frish M, Goedert JJ, Biggar RJ, Miller RW. Merkel cell carcinoma and HIV infection. Lancet 2002; 359:497-498.: National Cancer Institute study that found that immune suppression from HIV increased MCC risk by roughly 8-fold.

2. Penn I, First MR. Merkel's cell carcinoma in organ recipients: report of 41 cases. Transplantation 1999; 68:1717-21.: University of Cincinnati study that concluded that organ transplant patients, on drugs that suppress the immune system, have a roughly 10-fold higher risk of developing MCC, which proved to be more aggressive in this patient population

Staging and Sentinel Lymph Node Biopsy

1. Allen PJ, Bowne WB, Jaques DP, Brennan MF, Busam K, Coit DG. Merkel cell carcinoma: prognosis and treatment of patients from a single institution. Journal of Clinical Oncology 2005; 23:2300-09.: Study of 251 patients from Memorial Sloan-Kettering Cancer Center that concluded that 1) stage at presentation was an independent predictor of survival and 2) patients with pathologically negative lymph node involvement have an excellent prognosis.

2. Allen PJ, Zhang Z-F, Coit DG. Surgical management of Merkel cell carcinoma. Annals of Surgery 1999; 229:97-105.: Study of 102 patients from Memorial Sloan-Kettering Cancer Center that concluded that 1) tumor size at presentation was an independent predictor of survival for stage I disease, 2) the lymph nodes were the most common site of first recurrence, and 3) elective lymph node dissection decreased the rate of recurrence, but was not associated with improved overall survival.

3. Gupta SG, Wang LC, Penas PF, Gellenthin M, Lee SJ, Nghiem P. Sentinel lymph node biopsy for evaluation and treatment of patients with Merkel cell carcinoma: The Dana-Farber experience and meta-analysis of the literature. Archives of Dermatology 2006; 142:685-90. Click here for a PDF.: Series of MCC cases from Dana-Farber Cancer Institution and published cases found that sentinel lymph node biopsy improved staging accuracy and was thus important for prognosis and treatment.

4. Perrott RE, Glass FI, Reintgen DS, Fenske NA. Reassessing the role of lymphatic mapping and sentinel lymphadenectomy in the management of cutaneous malignant melanoma. Journal of the American Academy of Dermatology 2003; 49:567-588.

Radiation and MCC

1. Lewis KG, Weinstock MA, Weaver AL, Otley CC. Adjuvant local irradiation for Merkel cell carcinoma. Archives of Dermatology 2006; 142:693-700. Click here for a PDF.: Review of literature on MCC found that surgery plus local irradiation for treatment of MCC resulted in lower rates of local and regional recurrence compared to surgery alone.

2. Longo MI, Nghiem P. Merkel cell carcinoma treatment with radiation: a good case despite no prospective studies. Archives of Dermatology 2003; 139:1641-1643. Click here for a PDF.: Editorial that accompanied Mortier, et al paper discussing the importance of adjuvant radiation therapy and a proposed algorithm for MCC treatment.

3. Mortier L, Mirabel X, Fournier C, Piette F, Lartigau E. Radiotherapy alone for primary Merkel cell carcinoma. Archives of Dermatology 2003; 139:1587-1590.: French study of stage I MCC that found no difference in overall survival in treatment with radiation therapy alone (9 patients) compared with surgery and radiation therapy (17 patients).

4. Poulsen M, Rischin D, Walpole E, Harvey J, Mackintosh J, Ainslie J, Hamilton C, Keller J, Tripcony L. High-risk Merkel cell carcinoma of the skin treated with synchronous carboplatin/etoposide and radiation: a Trans-Tasman Radiation Oncology Group Study--TROG 96:07. Journal of Clinical Oncology 2003; 21:4371-4376.: Australian phase II study of 53 patients with stage I and II MCC treated with both chemotherapy (carboplatin/etoposide) and radiation therapy. This study showed 76% overall survival at 3 years, which was roughly similar, but perhaps better, than expected from previous studies. This study was not randomized nor controlled.

Merkel Cell Polyomavirus

1. Garneski KM, Decaprio JA, Nghiem P. Does a new polyomavirus contribute to Merkel cell carcinoma? Genome Biol 2008;9(6):228.

A review of polyomavirus biology and its possible relation to cancer.

2. Garneski KM, Warcola AH, Feng Q, Kiviat N, Leonard JH, Nghiem P. Merkel Cell Polyomavirus Is More Frequently Present in North American than Australian Merkel Cell Carcinoma Tumors. Journal of Investigative Dermatology 2008, in press.

North American and Australian tumor samples were evaluated for presence of MCPyV and a higher incidence in North American samples were positive for MCPyV when compared to Australia, suggesting a possible strain variant.

3. Feng H, Shuda M, Chang Y, Moore P. Clonal Integration of a Polyomavirus in Human Merkel Cell Carcinoma. Science 2008; 319:1096-1100

A technique called digital transcriptome subtraction (DTS) was used to identify a new virus, which is a previously unknown polyomavirus that we call Merkel cell polyomavirus (MCV or MCPyV). MCPyV sequences were detected in 8 of 10 (80%) MCC tumors (lower incidence in non-MCC tumors).

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