Lack of efficacy of radiation therapy plus PD-L1 blockade for Merkel cell carcinoma arising in a patient with chronic active Epstein-Barr virus infection

January 5, 2021


Dermatologic Therapy

Publication Date

January 5, 2021


Ayaka Okazaki, Kozo Nakai, Nao Kusutani, Riei Kamo, Yoshie Fukunaga, Kotaro Nagase, Paul Nghiem, Daisuke Tsuruta


Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer that occurs in elderly patients. The risk of MCC is increased by immunosuppression due to conditions such as human immunodeficiency virus infection, hematological malignancies, and organ transplantation. These risk factors can also be associated with a poor prognosis in MCC. Chronic active Epstein-Barr virus (CAEBV) infection is a rare Epstein-Barr virus (EBV) infectious disease characterized by persistent infectious mononucleosis-like symptoms. Recently, programmed cell death ligand 1 (PD-L1) blockade using avelumab was approved as the first-line therapy for patients with metastatic MCC. Here, we report a case of extremely hyperprogressive MCC occurring in a patient with CAEBV.

View the clinical publication