Liu Jessica, Olino Kelly, Lustberg Maryam, Kanowitz Jane
Yale University, New Haven, CT, United States.
Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States.
Front Oncol. 2025 Aug 27;15:1579287. doi: 10.3389/fonc.2025.1579287. eCollection 2025.
We present a case of a 98-year-old patient with metastatic Merkel cell carcinoma (MCC), a rare and aggressive neuroendocrine skin cancer, and locally advanced triple-negative breast cancer (TNBC), who achieved durable remission of both diseases with anti-PD-1 pembrolizumab monotherapy. This case is particularly significant to clinical management of advanced cutaneous malignancy in the elderly, who are historically underrepresented in clinical trials, as it demonstrates the remarkable efficacy of pembrolizumab alone while avoiding toxicities associated with traditional chemotherapy. The regression of the MCC lesion is noteworthy given the typically poor prognosis of metastatic MCC in geriatric patients. This experience contributes to the growing body of evidence supporting immunotherapy as a well-tolerated option for older adult patients with advanced skin and/or breast cancers, particularly when careful toxicity screening is employed for patient selection.
我们报告了一例98岁的患者，患有转移性默克尔细胞癌（MCC，一种罕见且侵袭性强的神经内分泌皮肤癌）和局部晚期三阴性乳腺癌（TNBC），该患者通过抗程序性死亡蛋白1（PD-1）的帕博利珠单抗单药治疗实现了两种疾病的持久缓解。该病例对于老年晚期皮肤恶性肿瘤的临床管理尤为重要，因为在历史上老年人在临床试验中的代表性不足，此病例显示了帕博利珠单抗单药的显著疗效，同时避免了与传统化疗相关的毒性。鉴于老年患者转移性MCC的预后通常较差，MCC病变的消退值得关注。这一经验为越来越多的证据提供了补充，这些证据支持免疫疗法作为老年晚期皮肤和/或乳腺癌患者耐受性良好的选择，特别是在对患者进行仔细的毒性筛查以进行患者选择时。
