Meredith Cummins our NSW Project Officer recently attended this event.
Read her recount below....
An education evening was recently held on 10th May at the Poche Centre. During
the evening I had the opportunity to meet the Chair of the AMIGO's Australasian Merkel Cell Patient Advocacy Group and to
liaise with the multidisciplinary health professionals in attendance. There
have been advances in the management of Merkel Cell Carcinoma (MCC) however
there is still much work to be done for this uncommon cancer. The first
presentation was given from a dermatology perspective – the presence of positive
MCV mutation is a better prognosis. The use of acronym AEIOU in diagnosis of
MCC – A - asymptomatic, E-expending, I - Immune Compromise, O – older than 50yrs and U- UV exposure is
reported that 90% of MCC patients have 3 or greater of the 5 criteria. The
pathology is difficult to differentiate. The role of surgery can be diagnosis,
staging, loco-regional treatment and salvage of recurrent disease. Staging used
is AJCC (T classification) – 27 – 31% with lymphadenopathy. Sentinel Node
Biopsy being performed often means that Adjuvant Radiation Therapy can be avoided;
however, there is a high false negative rate in MCC. From Radiation Oncology
perspective MCC is radiosensitive and doses of Radiation Therapy are around 60
– 66 Grey. Discussion was had regarding
FDG PET imaging and it was stated that FDG likes MCC with 95 % sensitivity in
Stage 2 and 3 disease. Medical Oncology management was presented which
discussed the use of chemotherapy and immune – oncology agents. Somatostatins
can be used as can Lutetium. The new immune-oncology agents such as Avelumab
have shown an early response and can maintain response for 12 – 18 months.
Several trials have reported that immune-oncology agents can be useful in positive
and negative PDL1 candidates. Finally work into multispectral
immunohistochemistry involving viruses was presented.
The Pharmaceutical Benefits Advisory Committee (PBAC) is currently reviewing the drub Avelumab in the treatment of MCC. If you would like to make a submission as to the importance of more treatment options for rare cancers including MCC, deadline is June 6th click here