Clinical Utility of a Novel Assay for Tracking Tumor Burden in Merkel Cell Carcinoma

Merkel cell carcinoma is an aggressive skin cancer that is typically driven by a common polyomavirus. The requirement of viral proteins to drive the growth of cancer cells has provided important clues as to how this cancer can be tracked and treated. Antibodies to the polyomavirus 'oncoprotein' increase and decrease in parallel with the amount of this cancer in patients. This observation serves as the basis of a test (made clinically available in January 2014 by UW Lab Medicine) that can detect early recurrence of this cancer, and reassure patients who are not experiencing a recurrence. The T cell mediated response to the viral proteins expressed in the cancer is strongly linked to survival. The fact that the T cells that recognize this cancer frequently show signs of 'exhaustion' serves as the basis for ongoing clinical trials of emerging immune stimulating agents that augment T cell function.

Paul Nghiem, MD, PhD,

3/5/2014

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