Avelumab in the Treatment of Advanced Merkel Cell Carcinoma: A Systematic Review

February 3, 2024


Dermatologic Surgery

Publication Date

February 3, 2024


Sharma A N, Shah K, Sharma A A, Yu S

Merkelcell.org Summary

Avelumab, also known as Bavencio, is an immunotherapy (drug that helps the immune system fight cancer) used to treat MCC. To get a bigger picture of how well avelumab works for treating MCC, researchers looked at results from 48 different studies. 1,565 patients treated with avelumab were included, and nearly all of them had “advanced MCC” that had spread to other parts of the body (stage IV). Avelumab worked either fully or partially in 46% of these patients and 58% were still alive a year after the treatment, showing that avelumab can be successful in treating advanced MCC. Since these results are from many different studies, it gives doctors and patients a better understanding of how well avelumab works.


Background: Avelumab, a programmed death ligand-1 inhibitor, has shown success in providing durable responses for difficult-to-treat Merkel cell carcinomas (MCCs).

Objective: Evaluate the efficacy and safety of avelumab in the treatment of advanced MCC.

Methods: Studies reporting the use of avelumab as a monotherapy or in combination with other agents in the treatment of stage III or IV (advanced) MCC were included. The primary outcomes were overall response rate, overall survival (OS), and treatment-related adverse events.

Results: A total of 48 studies were included, involving 1,565 patients with advanced MCC. Most patients were male (1,051, 67.3%) with stage IV MCC (517, 97.0%). The overall response rate was 46.1% (partial response-25.4% and complete response-20.7%) after a mean follow-up period of 9.5 months. Kaplan-Meier survival curves for the pooled stage III and IV group demonstrated OS rates of 58% at 1 year, 47% at 2 years, and 28% at 5 years after completion of treatment with avelumab (median OS: 23.1 months). The most common treatment-related adverse events consisted of constitutional (44%), gastrointestinal (19%), and dermatologic (12%) symptoms.

Conclusion: Avelumab monotherapy and combination therapy have shown success in the overall response rate and survival for patients with advanced MCC.

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