Background: Merkel cell carcinoma (MCC) is an aggressive skin cancer with poor survival rates. Immune checkpoint inhibitors (ICIs) were FDA-approved for advanced MCC in 2017, but their real-world survival impact remains unclear.
Objective: Evaluate whether ICI introduction in the US corresponded with improved survival.
Methods: This cohort study analyzed SEER data for MCC patients diagnosed from 2010 to 2021, grouped by 3-year periods, to calculate 2-year overall and relative survival.
Results: For 453 patients with metastatic MCC, 2-year relative survival improved from 23% (2010-2012) to 37% (2013-2015), 42% (2016-2018), and 54% (2019-2021) (p < 0.001). Median overall survival also increased from 9 to 16 months among these patients. In 4,786 MCC patients overall, 2-year relative survival rose from 73% (2010-2012) to 81% (2019-2021) (p = 0.004), while overall survival improved from 67% to 72% (p = 0.012).
Limitations: SEER lacks case-level data to link ICI treatment directly to survival, although ICIs represent the major recent treatment advance for MCC.
Conclusions: The introduction of ICIs aligns with a >2-fold increase in survival for advanced MCC patients at the population level, translating to ∼220 fewer deaths per year in the U.S.
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