title: Induction of durable responses by oral etoposide monochemotherapy in patients with metastatic Merkel cell carcinoma.
abstract: Merkel cell carcinoma (MCC) is an aggressive, rare tumour of the skin. For advanced cases with distant organ metastases several different regimens of chemotherapeutics have been described. Disease specific 5-year survival rates for these patients are approximately 11%. In this case series we report our experience with orally administered etoposide (100 mg at days 1 to 10 in a 31 day cycle) in 4 patients. We treated two male and two female patients with a median age of 68.5 years. In our four treated patients the disease control rate (complete remission, partial remission, stable disease) was 100%. Three out of four patients reached complete remission. Promisingly, two of our patients had long lasting, durable responses which, until now, have lasted for 16 and 36 months, respectively. The mean follow up time after start of therapy was 14.25 months (range 1-36 months). Etoposide treatment was generally well tolerated, the most common side effect was neutropenia, in one case CTC grade 3. In conclusion, orally administered etoposide in metastatic Merkel cell carcinoma was highly effective and well tolerated.
authors.affiliation: University Hospital of Cologne, Skin Cancer Center, Cologne, Germany. max.schlaak@uk-koeln.de
authors.forename: Max
authors.initials: M
authors.lastname: Schlaak
authors.forename: Tina
authors.initials: T
authors.lastname: Podewski
authors.forename: Wibke
authors.initials: W
authors.lastname: Von Bartenwerffer
authors.forename: Nicole
authors.initials: N
authors.lastname: Kreuzberg
authors.forename: Christopher
authors.initials: C
authors.lastname: Bangard
authors.forename: Cornelia
authors.initials: C
authors.lastname: Mauch
authors.forename: Peter
authors.initials: P
authors.lastname: Kurschat
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015266:Carcinoma, Merkel Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009503:Neutropenia / Q000209:etiology; D012074:Remission Induction; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide