Carcinoma de células de Merkel: patogénesis, manejo y tratamientos emergentes

Palabras clave: Poliomavirus de células de Merkel, neoplasias cutáneas, radioterapia, inmunoterapia

Resumen

El carcinoma de células de Merkel es un tumor raro neuroendocrino, altamente agresivo con altas tasas de mortalidad asociadas a sus metástasis a distancia. Es más frecuente en pacientes inmunosupresos, edad avanzada y exposición a luz ultravioleta. La mayoría de asocian con Poliomavirus sin embargo existen casos sin presencia viral. Se recomienda la resección quirúrgica con márgenes extensos cuando se encuentra localizado y en casos seleccionados la biopsia de ganglio centinela. Es una neoplasia quimiosensible y radiosensible. Existen avances terapéuticos inmunológicos para casos avanzados.

Biografía del autor

Daniel Esteban Barquero Orias, Dr, Investigador independiente, San José, Costa Rica

Médico general, graduado de la Universidad de Ciencias Médicas (UCIMED). Correo: daniel.barquero95@hotmail.com

Denis Ulises Landaverde Recinos, Dr, Hospital México, San José, Costa Rica

Especialista en Oncología Médica, graduado de la Universidad de Costa Rica (UCR). Código medico:6103. Correo: denislandaverde@gmail.com  ORCID:https://orcid.org/0000-0002-6522-1061

Jimena María Segura Guevara, Dra, Investigador independiente, San José, Costa Rica

Médico general, graduado de la Universidad de Costa Rica (UCR). Correo: segurajime01@gmail.com

Citas

1. Brummer G, Bowen A, Bowen G. Merkel Cell Carcinoma: Current Issues Regarding Diagnosis, Management, and Emerging Treatment Strategies. American Journal of Clinical Dermatology. 2015;17(1):49-62. https://doi.org/10.1007/s40257-015-0163-3

2. Chteinberg E, Sauer C, Rennspiess D, Beumers L, Schiffelers L, Eben J et al. Neuroendocrine Key Regulator Gene Expression in Merkel Cell Carcinoma. Neoplasia. 2018;20(12):1227-1235. https://doi.org/10.1016/j.neo.2018.10.003

3. Tsai S, Bordeaux J. Merkel Cell Carcinoma. A Practical Guide to Skin Cancer. 1 ed. Nashville: Springer; 2018. 143-153p.

4. Trinidad CM, Torres-Cabala CA, Prieto VG, Aung PP. Update on eighth edition American Joint Committee on Cancer classification for Merkel cell carcinoma and histopathological parameters that determine prognosis. Journal of Clinical Pathology. 2019 01 13; ID jclinpath-2018-205504. https://doi.org/10.1136/jclinpath-2018-205504

5. Tai P, Au J. Skin cancer management—updates on Merkel cell carcinoma. Annals of Translational Medicine. 2018; 6(14): 282-282. https://doi.org/10.21037/atm.2018.06.13

6. Schmults C, Blitzblau R, Aasi S, Alam M, Andersen J, Bordeaux J et al. Merkel Cell Carcinoma [Internet]. USA: National Comprehensive Cancer Network; 2019 [cited 12 March 2019]. Available from: https://merkelcell.org/wp-content/uploads/2017/10/MCC_v.2.2019-2.pdf

7. Bishop A, Garden A, Gunn G, Rosenthal D, Beadle B, Fuller C et al. Merkel cell carcinoma of the head and neck: Favorable outcomes with radiotherapy. Head & Neck. 2015;38(S1):E452-E458. https://doi.org/10.1002/hed.24017

8. Veness M. Radiation Therapy in Merkel Cell Carcinoma [internet]. Cham: Radiation Oncology. 2018 April 18 [cited 12 March 2019]. Available from: https://link.springer.com/referenceworkentry/10.1007/978-3-319-52619-5_16-1

9. Lebbe C, Becker J, Grob J, Malvehy J, del Marmol V, Pehamberger H et al. Diagnosis and treatment of Merkel Cell Carcinoma. European consensus-based interdisciplinary guideline. European Journal of Cancer. 2015;51(16):2396-2403. https://doi.org/10.1016/j.ejca.2015.06.131

10. Becker J, Stang A, DeCaprio J, Cerroni L, Lebbé C, Veness M et al. Merkel cell carcinoma. Nature Reviews Disease Primers. 2017;3:17077. https://doi.org/10.1038/nrdp.2017.77

11. Schadendorf D, Lebbé C, zur Hausen A, Avril M, Hariharan S, Bharmal M et al. Merkel cell carcinoma: Epidemiology, prognosis, therapy and unmet medical needs. European Journal of Cancer. 2017;71:53-69. https://doi.org/10.1016/j.ejca.2016.10.022

12. Riethdorf S, Hildebrandt L, Heinzerling L, Heitzer E, Fischer N, Bergmann S et al. Detection and Characterization of Circulating Tumor Cells in Patients with Merkel Cell Carcinoma. Clinical Chemistry. 2019;65(3):462-472. https://doi.org/10.1373/clinchem.2018.297028

13. Clarke C, Robbins H, Tatalovich Z, Lynch C, Pawlish K, Finch J et al. Risk of Merkel Cell Carcinoma After Solid Organ Transplantation. JNCI Journal of the National Cancer Institute. 2015;107(2):dju382-dju382. https://doi.org/10.1093/jnci/dju382

14. Harms P. Update on Merkel Cell Carcinoma. Clinics in Laboratory Medicine. 2017;37(3):485-501. https://doi.org/10.1016/j.cll.2017.05.004

15. Sahi H, Sihto H, Artama M, Koljonen V, Böhling T, Pukkala E. History of chronic inflammatory disorders increases the risk of Merkel cell carcinoma, but does not correlate with Merkel cell polyomavirus infection. British Journal of Cancer. 2016;116(2):260-264. https://doi.org/10.1038/bjc.2016.391

16. Liu W, MacDonald M, You J. Merkel cell polyomavirus infection and Merkel cell carcinoma. Current Opinion in Virology. 2016;20:20-27. https://doi.org/10.1016/j.coviro.2016.07.011

17. Shirley M. Avelumab: A Review in Metastatic Merkel Cell Carcinoma. Targeted Oncology. 2018;13(3):409-416. https://doi.org/10.1007/s11523-018-0571-4

18. Harms P, Harms K, Moore P, DeCaprio J, Nghiem P, Wong M et al. The biology and treatment of Merkel cell carcinoma: current understanding and research priorities. Nature Reviews Clinical Oncology. 2018;15(12):763-776. https://doi.org/10.1038/s41571-018-0103-2

19. Wong S, Waldeck K, Vergara I, Schroder J, Madore J, Wilmott J et al. UV-Associated Mutations Underlie the Etiology of MCV-Negative Merkel Cell Carcinomas. Cancer Research. 2015;75(24):5228-5234. https://doi.org/10.1158/0008-5472.CAN-15-1877

20. Veija T, Sarhadi V, Koljonen V, Bohling T, Knuutila S. Hotspot mutations in polyomavirus positive and negative Merkel cell carcinomas. Cancer Genetics. 2016;209(1-2):30-35. https://doi.org/10.1016/j.cancergen.2015.11.006

21. Chteinberg E, Sauer C, Rennspiess D, Beumers L, Schiffelers L, Eben J et al. Neuroendocrine Key Regulator Gene Expression in Merkel Cell Carcinoma. Neoplasia. 2018;20(12):1227-1235. https://doi.org/10.1016/j.neo.2018.10.003

22. Prieto I, de la Fuente T, Medina S, Castelo B, Sobrino B, Fortes J et al. Merkel cell carcinoma: An algorithm for multidisciplinary management and decision-making. Critical Reviews in Oncology/Hematology. 2016;98:170-179. https://doi.org/10.1016/j.critrevonc.2015.10.008

23. Cassler N, Merrill D, Bichakjian C, Brownell I. Merkel Cell Carcinoma Therapeutic Update. Current Treatment Options in Oncology. 2016;17(7):36. https://doi.org/10.1007/s11864-016-0409-1

24. Kline L, Coldiron B. Mohs Micrographic Surgery for the Treatment of Merkel Cell Carcinoma. Dermatologic Surgery. 2016;42(8):945-951. https://doi.org/10.1097/DSS.0000000000000801

25. Strom T, Carr M, Zager J, Naghavi A, Smith F, Cruse C et al. Radiation Therapy is Associated with Improved Outcomes in Merkel Cell Carcinoma. Annals of Surgical Oncology. 2016;23(11):3572-3578. https://doi.org/10.1245/s10434-016-5293-1

26. Mendenhall W, Morris C, Kirwan J, Amdur R, Shaw C, Dziegielewski P. Management of cutaneous Merkel cell carcinoma. Acta Oncologica. 2017;57(3):320-323. https://doi.org/10.1080/0284186X.2017.1349926

27. Chan I, Bhatia S, Kaufman H, Lipson E. Immunotherapy for Merkel cell carcinoma: a turning point in patient care. Journal for ImmunoTherapy of Cancer. 2018;6(1):23. https://doi.org/10.1186/s40425-018-0335-9

28. Hauschild A, Schadendorf D. Checkpoint inhibitors: a new standard of care for advanced Merkel cell carcinoma?. The Lancet Oncology. 2016;17(10):1337-1339. https://doi.org/10.1016/S1470-2045(16)30441-7

29. Colunga A, Pulliam T, Nghiem P. Merkel Cell Carcinoma in the Age of Immunotherapy: Facts and Hopes. Clinical Cancer Research. 2017;24(9):2035-2043. https://doi.org/10.1158/1078-0432.CCR-17-0439

30. Galluzzi L, Kroemer G. Novel immune checkpoint blocker to treat Merkel cell carcinoma. OncoImmunology. 2017;6(6):e1315496. https://doi.org/10.1080/2162402X.2017.1315496
Publicado
2019-05-01
Cómo citar
Barquero Orias, D., Recinos, D. U., & Guevara, J. M. (2019). Carcinoma de células de Merkel: patogénesis, manejo y tratamientos emergentes. Revista Medica Sinergia, 4(5), 15 - 23. https://doi.org/https://doi.org/10.31434/rms.v4i5.189
Sección
Artículos de Revisión

##plugins.generic.recommendByAuthor.heading##