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Drusbosky L, Nangia C, Nguyen A, Szeto C, Newton Y, Spilman P, Reddy SB. Complete response to avelumab and IL-15 superagonist N-803 with Abraxane in Merkel cell carcinoma: a case study. J Immunother Cancer 2020; 8:jitc-2020-001098. [PMID: 32913030 PMCID: PMC7484858 DOI: 10.1136/jitc-2020-001098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 12/14/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare aggressive form of skin cancer originating in neuroendocrine cells. The antiprogrammed death ligand 1 (PD-L1) monoclonal antibody (mAb) avelumab has been approved for treatment of MCC, but options are limited, should it be ineffective as a monotherapy. Combined therapy with low/moderate dose nab-paclitaxel and an interleukin 15 (IL-15)-based therapeutic such as the IL-15 ‘superagonist’ N-803 may increase response by activation of the immune system. The case of a 71-year-old man diagnosed with MCC who achieved and maintained a complete response (CR) by treatment with the anti-PD-L1 mAb avelumab in combination with IL-15 superagonist N-803 and nab-paclitaxel (Abraxane) is presented. Avelumab treatment alone resulted in a response in a para-aortic lesion, but not the other tumor masses. N-803 was added, followed by nab-paclitaxel; CT showed a decrease in the size of the abdominal mass at 1 month, near resolution at 3 months and CR at 5 months. Abraxane was discontinued after the first CR on CT, and the patient continues on avelumab/N-803 treatment and maintains a CR. Combination of avelumab with low/moderate-dose chemotherapy and an immune enhancer such as N-803 may offer a viable treatment option for MCC patients for whom avelumab therapy alone was not effective.
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Affiliation(s)
| | - Chaitali Nangia
- Chan Soon-Shiong Institute for Medicine, El Segundo, California, USA
| | - Andrew Nguyen
- NantHealth Inc, Culver City, California, USA.,ImmunityBio, LLC, Culver City, California, USA
| | - Christopher Szeto
- NantHealth Inc, Culver City, California, USA.,ImmunityBio, LLC, Culver City, California, USA
| | - Yulia Newton
- NantHealth Inc, Culver City, California, USA.,ImmunityBio, LLC, Culver City, California, USA
| | | | - Sandeep Bobby Reddy
- NantHealth Inc, Culver City, California, USA .,ImmunityBio, LLC, Culver City, California, USA
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