NantHealth Inc, Culver City, California, USA.
Chan Soon-Shiong Institute for Medicine, El Segundo, California, USA.
J Immunother Cancer. 2020 Sep;8(2). doi: 10.1136/jitc-2020-001098.
Merkel cell carcinoma (MCC) is a rare aggressive form of skin cancer originating in neuroendocrine cells. The antiprogrammed death ligand 1 (PD-L1) monoclonal antibody (mAb) avelumab has been approved for treatment of MCC, but options are limited, should it be ineffective as a monotherapy. Combined therapy with low/moderate dose nab-paclitaxel and an interleukin 15 (IL-15)-based therapeutic such as the IL-15 'superagonist' N-803 may increase response by activation of the immune system. The case of a 71-year-old man diagnosed with MCC who achieved and maintained a complete response (CR) by treatment with the anti-PD-L1 mAb avelumab in combination with IL-15 superagonist N-803 and nab-paclitaxel (Abraxane) is presented. Avelumab treatment alone resulted in a response in a para-aortic lesion, but not the other tumor masses. N-803 was added, followed by nab-paclitaxel; CT showed a decrease in the size of the abdominal mass at 1 month, near resolution at 3 months and CR at 5 months. Abraxane was discontinued after the first CR on CT, and the patient continues on avelumab/N-803 treatment and maintains a CR. Combination of avelumab with low/moderate-dose chemotherapy and an immune enhancer such as N-803 may offer a viable treatment option for MCC patients for whom avelumab therapy alone was not effective.
默克尔细胞癌（Merkel cell carcinoma，MCC）是一种起源于神经内分泌细胞的罕见侵袭性皮肤癌。抗程序化死亡配体 1（PD-L1）单克隆抗体（mAb）avelumab 已被批准用于治疗 MCC，但如果作为单一疗法无效，选择有限。低/中剂量 nab-紫杉醇与白细胞介素 15（IL-15）为基础的治疗药物（如 IL-15“超级激动剂”N-803）联合治疗可能通过激活免疫系统增加反应。本文报告了一例 71 岁男性 MCC 患者，接受抗 PD-L1 mAb avelumab 联合 IL-15 超级激动剂 N-803 和 nab-紫杉醇（Abraxane）治疗后获得并维持完全缓解（CR）。单独使用 avelumab 治疗导致主动脉旁病变有反应，但其他肿瘤块没有反应。加入 N-803，然后加入 nab-紫杉醇；CT 显示腹部肿块大小在 1 个月时减小，3 个月时接近缓解，5 个月时达到 CR。CT 显示首次 CR 后停用 Abraxane，患者继续使用 avelumab/N-803 治疗并维持 CR。avelumab 联合低/中剂量化疗和免疫增强剂（如 N-803）的联合治疗可能为 avelumab 治疗无效的 MCC 患者提供一种可行的治疗选择。
