Neoadjuvant polychemotherapy in locally advanced Merkel cell carcinoma

Nat Rev Clin Oncol. 2009 Sep;6(9):544-8. doi: 10.1038/nrclinonc.2009.109.


Background: A 72-year-old man presented with a Merkel cell carcinoma (MCC) of the left cheek with concomitant nodal spread. A 61-year-old man presented with an MCC of the right thigh with rapid nodal recurrence.

Investigations: Skin biopsy samples proved the MCC nature of the neoplasm in both patients. Staging procedure included clinical and radiological investigations.

Diagnosis: Advanced stage II MCC.

Management: Neoadjuvant cisplatin, etoposide and cyclophosphamide (EPC) regimen led to local control in the first patient and allowed curative surgery associated with adjuvant radiation therapy. Complete remission was maintained for 32 months. The second patient was treated by surgery plus radiation therapy. Nodal and cutaneous recurrences were treated with a neoadjuvant EPC regimen leading to a 5-year complete remission.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Merkel Cell / drug therapy*
  • Carcinoma, Merkel Cell / pathology*
  • Carcinoma, Merkel Cell / radiotherapy*
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Etoposide / administration & dosage
  • Humans
  • Male
  • Meta-Analysis as Topic
  • Middle Aged
  • Neoadjuvant Therapy / methods
  • Neoplasm Staging
  • Radiotherapy, Adjuvant / methods
  • Remission Induction
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Survival Analysis


  • Etoposide
  • Cyclophosphamide
  • Cisplatin