Lack of Clinically Significant Relationships of Age or Body Mass Index with Merkel Cell Carcinoma Immunotherapy Outcomes

Author:

Alam Rian1,Fan Xinyi2,Hippe Daniel S.2ORCID,Tachiki Lisa M.23,Gong Emily1,Huynh Emily14ORCID,Nghiem Paul1ORCID,Park Song Youn1ORCID

Affiliation:

1. Department of Dermatology, University of Washington, Seattle, WA 98109, USA

2. Fred Hutchinson Cancer Center, Clinical Research Division, Seattle, WA 98109, USA

3. Division of Hematology/Oncology, Department of Medicine, University of Washington, Seattle, WA 98109, USA

4. College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA 98901, USA

Abstract

Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a high risk of metastasis. The development of anti-PD-1/PD-L1 immunotherapy has improved outcomes for advanced MCC, yet about 50% of such patients do not achieve durable responses. This study analyzed the effects of age and body mass index (BMI) on immunotherapy response in 183 advanced MCC patients from a single-center longitudinal database. Using Fine–Gray or Cox regression models, treatment response, progression-free survival (PFS), MCC-specific survival, and overall survival (OS) were evaluated. Age showed a significant non-linear relationship with treatment response (p = 0.04), with patients much older or younger than 70 years less likely to respond. However, age was not significantly associated with PFS (p = 0.21), MCC-specific survival (p = 0.72), or OS (p = 0.36). Similarly, BMI was not significantly correlated with treatment response (p = 0.41), PFS (p = 0.52), MCC-specific survival (p = 0.78), or OS (p = 0.71). Unlike previous studies suggesting that obesity and advanced age improve outcomes in other cancers, these associations were not observed in MCC. These findings suggest that age and BMI should not influence eligibility for immunotherapy in MCC patients, emphasizing the importance of unbiased patient selection for this treatment.

Funder

NIH/NCI

Kelsey Dickson Team Science Courage Research Award

MCC Gift Fund

Publisher

MDPI AG

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