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  • Writer's pictureLighthouse

Trending and Awareness for Merkel Cell Carcinoma

Updated: Mar 7, 2023

Summary in Thirty Seconds

  • Merkel Cell Carcinoma (MCC) is a rare yet very aggressive type of skin cancer with two currently FDA-approved immunotherapies (IO) and over 10 clinical trials currently ongoing.

  • We evaluated trending and awareness for MCC in North American and European oncologists and North American dermatologists over the past decade.

  • Trending spikes for both MCC and MCC plus IO arise at the time the first immunotherapeutic agents were approved by the FDA.

  • Dermatologists have generally higher levels of trending and consistently higher levels of awareness for MCC than their oncology colleagues. However, when looking at trending and awareness for the combination of MCC and IO, the pattern reverses.

  • Dermatologists appear to be focused on non-IO aspects of MCC (e.g., origins, epidemiology, diagnosis, surgical treatment, radiotherapy, etc.); whereas oncologists in North America and Europe emphasize IO treatments for MCC.

Merkel Cell Carcinoma

Merkel Cell Carcinoma (MCC) is a rare yet very aggressive type of skin cancer.[1] The incidence rate of MCC has been rising worldwide, with a range of 1,500 to 3,000 new cases in the US diagnosed annually.[2] There are currently two approved immunotherapies FDA-approved for MCC, with over 10 clinical trials currently ongoing studying immunotherapeutic agents for MCC.[3] In 2017, avelumab was approved for MCC,[4] and pembrolizumab was approved in late 2018.[5]


In this brief context, we evaluated trending and awareness for MCC in North American and European oncologists and North American dermatologists over the past decade, yielding the following results:

Trending spikes for both MCC and MCC plus IO arise at the time the first immunotherapeutic agents were approved by the FDA. It is unclear why dermatologists showed a trending dip in both MCC and MCC plus IO in 2019. When comparing disciplines, for MCC alone, dermatologists have generally higher levels of trending and consistently higher levels of awareness than their oncology colleagues. However, when looking at trending and awareness for the combination of MCC and IO, the pattern reverses, with North American oncologists far outpacing European oncologists and dermatologists.


Percentage of Trending in MCC attributable to MCC plus Immunotherapy

To further assess these patterns, we looked at the percentage of trending for the combination of MCC plus IO over the total trending for MCC. Here a clear pattern is revealed:


From 2017, when the first immunotherapy was FDA-approved, the two oncologist groups show that a majority of their trending for MCC is attributable to MCC plus IO, and after 2017, that percentage is greater than 75%. However, the dermatologists only show a majority of their MCC trending coming from MCC plus IO one time (in 2020); otherwise, the percentage of their MCC trending attributable to MCC plus IO hovers around 25%. Therefore, it appears that dermatologists are focused on other aspects of MCC (e.g., origins, epidemiology, diagnosis, surgical treatment, radiotherapy, etc.); whereas oncologists in North America and Europe emphasize immunotherapeutic treatments for MCC as these have emerged since 2017-2108 and where numerous clinical trials are ongoing. Given the specific focus of these disciplines, such a pattern makes sense.


Conclusion

This analysis is different than our previous work inasmuch as it focuses on a type of cancer and treatment for that cancer as opposed to evaluating various biomarkers. Nevertheless, these results show the diversity to which trending and awareness patterns can be applied. The patterns seen here may be used to help target what to emphasize for different professional disciplines, given the varying levels of trending and awareness seen in this analysis.

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