Treatment of Stage IV Merkel Cell Carcinoma

Stage IV Merkel cell carcinoma (MCC) includes patients with distant metastases.

Single-agent immunotherapy is the preferred initial systemic therapy for patients with metastatic disease. Chemotherapy may be considered for patients with stage IV disease who have a good performance status and are either ineligible for or have disease progression while receiving immunotherapy. Although responses have been seen with various regimens, evidence is lacking that chemotherapy results in permanent disease control or long-term survival.

If chemotherapy is not considered an appropriate option, patients with stage IV disease may consider surgery and/or radiation therapy for local or regional palliation.