A RECENT systematic review of Merkel cell carcinoma (MCC) treatment in solid organ transplant (SOT) recipients reveals an urgent need for clearer treatment guidelines. While the incidence of MCC is rising among transplant patients, there are no established protocols for managing this rare and aggressive skin cancer in this population.
The review, which included 30 studies, 21 case reports, eight cohort studies, and one clinical trial, provides insight into the treatment landscape for MCC in transplant recipients. Surgery remains the most common treatment, employed in 77.7% of cases, followed by radiotherapy (62.9%) and chemotherapy (25.9%). Notably, a few patients have been treated with immune checkpoint inhibitors, and one received an oncolytic virus. The cohort studies also presented various treatment regimens, which included surgery, radiotherapy, chemotherapy, and adjustments to immunosuppressive therapy.
However, the review highlights significant variability in the treatment approaches due to methodological differences across the studies. The lack of stratified data on immunosuppressed populations further complicated efforts to make direct comparisons. Despite these challenges, the review underscores the potential of oncolytic virotherapy to provide targeted treatment with fewer side effects, making it a promising option for patients with MCC after organ transplant.
The study calls for the inclusion of SOT recipients with MCC in future clinical trials, particularly those exploring combinations of immunotherapy and modifications in immunosuppressive regimens. These trials could help develop evidence-based treatment guidelines and optimize care for this vulnerable group of patients.
Reference:
Chin Kai Xian D et al. Treatment of Merkel cell carcinoma in organ transplant recipients—A systematic review. JAAD Int. 2025;19:75–82.
