Three Cases of Merkel Cell Carcinoma Treated With Lutetium‐177 Oxodotreotide

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ABSTRACT Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine skin cancer associated with early metastasis and poor outcomes in the advanced stages. Immune checkpoint inhibitors (ICIs), particularly avelumab, represent the first‐line therapy for metastatic MCC. However, effective treatment options after progression or intolerance remain limited. Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogs has emerged as a potential therapeutic option for tumors expressing somatostatin receptors (SSTRs). We present three patients with advanced MCC (aged 73, 45, and 77 years, respectively) treated with 177 Lu‐oxodotreotide after failure or intolerance of ICI therapy and cytotoxic chemotherapy. 111 In pentetreotide single photon emission computed tomography/computed tomography demonstrated SSTR uptake in all patients, supporting the rationale for PRRT. All patients ultimately experienced disease progression; however, one achieved transient disease stabilization with tumor reduction. The times from the first PRRT administration to death were 3.4, 4.2, and 1.4 months, respectively. No serious treatment‐related adverse events were observed. These findings suggest that 177 Lu‐oxodotreotide may represent a feasible and relatively safe option for patients with treatment‐refractory MCC, although its antitumor efficacy is limited. However, further prospective studies are required to elucidate its clinical role.

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