Merkel Cell Polyomavirus Antibody in Tumor and Plasma Specimens in Patients with Merkel Cell Carcinoma

Ann Surg Oncol. 2025 Jan;32(1):464-473. doi: 10.1245/s10434-024-16292-8. Epub 2024 Oct 7.

Abstract

Background: Merkel cell carcinoma (MCC) is associated with Merkel cell polyomavirus (MCPyV) infection. MCPyV antibodies (MCPyV-Ab) in plasma correlate with survival, while MCPyV-Ab within the tumor has never been investigated. This study evaluated plasma MCPyV-Ab and tumor MCPyV-Ab titers to evaluate their role in outcomes and prognostication.

Methods: A single-institution, prospective database was retrospectively reviewed for patients diagnosed with MCC from 2014 to 2021. MCPyV-Ab plasma and tumor titers, as well as patient and treatment factors, were collected. Two-year overall survival (OS) and disease-free survival (DFS) were examined based on MCPyV-Ab presence in tumor.

Results: Forty patients were identified, with a median follow-up of 27.6 months. Patients were stratified into four groups based on the presence of MCPyV-Ab in plasma (P+, P-) and tumor (T+, T-). Most patients (60.0%) were P-/T-. Of the remaining patients, 22.5% were P+/T+, 12.5% were P-/T+, and 5.0% were P+/T-. Two-year DFS of the P-/T- group was 16.6 months, which was not different from the other groups (p = 0.79). Two-year OS of P-/T- was 18.3 months, and 2-year OS of P-/T+ was 28.1 months, which was similar between groups (p = 0.80).

Conclusions: Most patients P+ for MCPyV had antibody-positive tumors (T+), and P- patients were also T-; however, there was a subset of patients where plasma and tumor antibody findings were incongruent. Patients with MCPyV-Ab in either plasma or tumor had a trend toward improved 2-year DFS and OS, but was limited by a small cohort. This study offers an exploratory investigation into the relationship between plasma and tumor antibodies to MCPyV on which to base future work.

Keywords: Merkel cell antibody; Merkel cell carcinoma; Merkel cell polyomavirus.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Viral* / blood
  • Carcinoma, Merkel Cell* / blood
  • Carcinoma, Merkel Cell* / immunology
  • Carcinoma, Merkel Cell* / pathology
  • Carcinoma, Merkel Cell* / virology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Merkel cell polyomavirus* / immunology
  • Middle Aged
  • Polyomavirus Infections* / blood
  • Polyomavirus Infections* / immunology
  • Polyomavirus Infections* / virology
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Skin Neoplasms* / blood
  • Skin Neoplasms* / immunology
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / virology
  • Survival Rate
  • Tumor Virus Infections* / blood
  • Tumor Virus Infections* / complications
  • Tumor Virus Infections* / immunology
  • Tumor Virus Infections* / virology

Substances

  • Antibodies, Viral