Merkel Cell Carcinoma: From Molecular Mechanisms to Clinical Therapy—a Selection of Papers from the 8th Nordic/1st European MCC Meeting

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Immunology and Immunotherapy".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 2064

Special Issue Editors


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1. Department of Dermatology, Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, University Duisburg-Essen, 47057 Essen, Germany
2. Translational Skin Cancer Research, DKTK Site Essen, ED03, Deutsches Krebsforschungszentrum (DKFZ), 69120 Heidelberg, Germany
Interests: skin cancer; tumor biology; tumor immunology; tumor evolution; biomarker; clinical trials; epidemiology
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Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
Interests: virology; viral carcinogenesis; molecular biology; skin cancer

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Guest Editor
Department of Dermatology and Venereology, University of Gothenburg, Gothenburg, Sweden
Interests: skin cancer; clinical trials; dermoscopy; dermatologic surgical procedures

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Guest Editor
Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
Interests: skin cancer; molecular biology; viral carcinogenesis; tumor immunology; biomarker
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We invite you to contribute to a Special Issue focused on Merkel cell carcinoma (MCC), a rare but highly informative skin cancer that offers unique insights into tumor biology and immunology. MCC's distinct characteristics make it an ideal subject for research aimed at translating scientific discoveries into clinical applications to enhance cancer care.

MCC presents two primary etiologies—virus-associated and UV-associated—both of which render the tumor highly immunogenic. This dual nature not only allows researchers to investigate the underlying carcinogenic mechanisms of this disease but also to explore its immunological responses, both spontaneous and therapeutically induced.

The MCC research community is known for its collaborative spirit, as demonstrated by the 8th Nordic/1st European MCC Meeting, where experts from around the globe gathered to share the latest findings in MCC molecular biology, immunology (including the impact of the tumor microenvironment), biomarkers, epidemiology, early diagnosis, current therapies, and clinical trials. This gathering also provided an opportunity to strategize on future directions in the fight against MCC and other cancers.

This Special Issue will compile papers on both basic and clinical research presented at the 8th Nordic/1st European MCC Meeting. We welcome submissions that advance our understanding of MCC and contribute to the broader field of cancer research.

Researchers are encouraged to submit their findings as either original articles, reviews, or brief communications.

Prof. Dr. Jürgen C. Becker
Prof. Dr. Nicole Fischer
Dr. John Paoli
Dr. Weng-Onn Lui
Guest Editors

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Keywords

  • merkel cell carcinoma
  • molecular biology
  • virology
  • immunology
  • biomarkers
  • epidemiology
  • primary treatment (surgery, radiation therapy)
  • immunotherapy
  • targeted therapy
  • clinical trials

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Published Papers (2 papers)

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Research

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13 pages, 2603 KiB  
Article
Low Intratumoral CD200 Protein Expression in Primary Merkel Cell Carcinoma Is a Strong Predictor for Disease Relapse
by Thilo Gambichler, Sophia Girke, Nessr Abu Rached, Laura Susok, Jürgen C. Becker, Hans-Joachim Schulze, Tobias Hirsch, Maximilian Kückelhaus and Sascha Wellenbrock
Cancers 2025, 17(5), 822; https://doi.org/10.3390/cancers17050822 - 27 Feb 2025
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Abstract
Background: Merkel cell carcinoma (MCC) is a rare and frequently fatal form of skin cancer. Apart from Programmed Cell Death Protein 1 (PD-1)/Programmed Death-Ligand 1 (PD-L1) signaling, there is a lack of knowledge regarding other immune checkpoint molecules. Recent studies have observed elevated [...] Read more.
Background: Merkel cell carcinoma (MCC) is a rare and frequently fatal form of skin cancer. Apart from Programmed Cell Death Protein 1 (PD-1)/Programmed Death-Ligand 1 (PD-L1) signaling, there is a lack of knowledge regarding other immune checkpoint molecules. Recent studies have observed elevated glycoprotein CD200 (also known as OX-2) mRNA expression in in different types of tumors, with CD200R-expressing myeloid cells present in the tumor microenvironment. However, the potential role of the CD200/CD200 axis as an additional checkpoint modulator remains widely unexplored. The aim of this study was to determine the intratumoral protein expression of CD200 as well as CD200R in a larger cohort of MCC patients and to correlate the expression levels with patients’ outcomes. Methods: In this multicenter study, we investigated 68 patients with MCC (68 primary tumors and 15 corresponding metastases). Immunohistochemistry (IHC) was performed for CD200 as well as CD200R. Digital quantification and analysis of IHC were performed using QuPath-0.2.3. Results: CD200 and CD200R expression was observed in 100% of cases. Univariate analysis revealed that low CD200 expression in primary tumors (p = 0.0007, HR 9.35), male sex (p = 0.045, HR 2.41), and immunosuppression (p = 0.0031, HR 6.36) were significantly associated with MCC relapse. Low CD200 expression was also linked to prior immune checkpoint inhibitors (ICI) and/or chemotherapy treatment (p = 0.037). Multivariable analysis confirmed that low CD200 expression (p = 0.0012, HR 5.25) and immunosuppression (p = 0.0056, HR 4.11) were independent predictors of MCC relapse. Conclusions: Expression of CD200/CD200R proteins is very high in MCC and may thus be of diagnostic value. More importantly, low intratumoral CD200 protein expression in primary MCC represents a robust independent predictor of MCC relapse. Full article
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Review

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12 pages, 7720 KiB  
Review
A Review of Non-Invasive Skin Imaging in Merkel Cell Carcinoma: Diagnostic Utility and Clinical Implications
by Iulia Maria Badiu, Katarzyna Korecka, Anca Olguta Orzan, Marco Spadafora, Caterina Longo, Ana-Maria Forsea and Aimilios Lallas
Cancers 2024, 16(21), 3586; https://doi.org/10.3390/cancers16213586 - 24 Oct 2024
Cited by 1 | Viewed by 1217
Abstract
Background/Objectives: Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine malignancy characterized by its propensity for rapid growth and early regional and distant metastasis. Given its potentially lethal nature, accurate and timely diagnosis of MCC is of utmost importance. This review [...] Read more.
Background/Objectives: Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine malignancy characterized by its propensity for rapid growth and early regional and distant metastasis. Given its potentially lethal nature, accurate and timely diagnosis of MCC is of utmost importance. This review aims to describe non-invasive imaging methods that can serve as additional tools in the examination of MCC. Methods: In this narrative review, we describe the up-to-date spectrum of non-invasive skin-imaging methods that can serve as additional tools in the examination of MCC based on the available literature. Dermoscopy might enhance the clinical diagnosis of MCC, facilitate differentiation from other benign and malignant tumors, and help optimize the treatment plan. New imaging technologies might also provide useful information at a sub-macroscopic level and support clinical diagnosis. These techniques include high-frequency ultrasound (HFUS), reflectance confocal microscopy (RCM) and optical coherence tomography (OCT). Results: Clinically, MCC typically presents as a rapidly growing, red, purple or skin-colored painless and firm nodule. Diagnosis is usually established with histopathological assessment and immunohistochemistry. However, dermoscopy and new imaging technologies might enhance the clinical diagnosis of MCC, facilitate differentiation from other benign and malignant tumors, and help optimize the treatment plan. Full article
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