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    The changing paradigm of managing Merkel cell carcinoma in Australia: An expert commentary

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    Author
    Kok, DL; Wang, A; Xu, W; Chua, MST; Guminski, A; Veness, M; Howle, J; Tothill, R; Kichendasse, G; Poulsen, M; ...
    Date
    2020-08-05
    Source Title
    Asia Pacific Journal of Clinical Oncology
    Publisher
    WILEY
    University of Melbourne Author/s
    Kok, David; Tothill, Richard; Sandhu, Shahneen
    Affiliation
    Clinical Pathology
    Sir Peter MacCallum Department of Oncology
    Metadata
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    Document Type
    Journal Article
    Citations
    Kok, D. L., Wang, A., Xu, W., Chua, M. S. T., Guminski, A., Veness, M., Howle, J., Tothill, R., Kichendasse, G., Poulsen, M., Sandhu, S. & Fogarty, G. (2020). The changing paradigm of managing Merkel cell carcinoma in Australia: An expert commentary. ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, 16 (6), pp.312-319. https://doi.org/10.1111/ajco.13407.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/252517
    DOI
    10.1111/ajco.13407
    Abstract
    Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine tumor of the skin with an estimated disease-associated mortality of 15-33%. Australia has a higher incidence of MCC compared to the rest of the world, thought to be due to a higher ultraviolet index. The Australian MCC population is distinct from the MCC population of the Northern hemisphere, characterized by a predominantly viral negative etiology with high tumor mutational burden. The optimal management of MCC and the choice of treatment modality vary significantly across the world and even between institutions within Australia. Historically, the treatment for MCC has been resection followed by radiotherapy (RT), though definitive RT is an alternative treatment used commonly in Australia. The arrival of immune checkpoint inhibitors and the mounting evidence that MCC is a highly immunogenic disease is transforming the treatment landscape for MCC. Australia is playing a key role in the further development of treatment options for MCC with two upcoming Australian/New Zealand investigator-initiated clinical trials that will explore the interplay of RT and immunotherapy in the treatment of early and late stage MCC.

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