ESMO 2025 | Comparing the role of adjuvant IO in Merkel cell carcinoma and melanoma
Janice Mehnert, MD, Perlmutter Cancer Center of NYU Langone Health, New York, NY, discusses the differences in treatment approaches for melanoma and Merkel cell carcinoma (MCC), highlighting that radiation is not typically used for local recurrences in melanoma, whereas it is a key treatment modality in Merkel cell carcinoma due to its radiosensitivity. The use of radiation can effectively prevent local recurrences, which may explain the observed lower local recurrence rate in patients with MCC treated with immunotherapy (IO) in the ECOG-ACRIN EA6174 (STAMP) trial (NCT03712605). This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
So this is a really important point because in melanoma, we don’t typically use radiation to treat local recurrences. We can if patients have, you know, very aggressive disease, but it’s usually not our first choice. In fact, many of our adjuvant trials did not have, did not permit radiation. Whereas in Merkel cell carcinoma, because it can be so exquisitely radiosensitive, it was important to have radiation delivered as part of the treatment modalities...
So this is a really important point because in melanoma, we don’t typically use radiation to treat local recurrences. We can if patients have, you know, very aggressive disease, but it’s usually not our first choice. In fact, many of our adjuvant trials did not have, did not permit radiation. Whereas in Merkel cell carcinoma, because it can be so exquisitely radiosensitive, it was important to have radiation delivered as part of the treatment modalities. And radiation can be a very effective tool to prevent local recurrences. So it makes sense what we’re seeing that perhaps the local recurrence rate was not as dramatic as we might expect, but the distant recurrence rate, which radiation does not protect against, was more pronounced in the patients that received immunotherapy.
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