Table 1.

Patient characteristics and treatment outcomes

Patient	1	2	3	4	5
Age (years) at first diagnosis	57	70	67	64	58
Sex	Male	Male	Male	Male	Female
Stage (UICC 2017)	IV	IV	IV	IV	IV
MCPyV	Positive	Positive	Negative	Negative	Positive
PD-L1	Negative	Negative	Negative	na	Negative
Avelumab
Number of courses	7	9	2	4	4
BOR (RECIST 1–1)	PD	SD	PD	PD	PD
irAE	–	PNP°II	Pneumonitis°II, Hepatitis °II	–	–
Subsequent therapies
Therapy 1	–	–	C + E*	C + E** + radiotherapy	C + E*
BOR (RECIST 1–1)	–	–	PD	PD	PR
Therapy 2	–	–	–	Nivolumab	Avelumab
BOR (RECIST 1–1)	–	–	–	SD/PD	PD
IPI/NIVO
LDH	Elevated	Elevated	Elevated	Normal	Elevated
CRP	1.16 mg/dl (ULN < 0.5)	0.9 mg/dl (ULN < 0.5)	0.52 mg/dl (ULN < 0.5)	1.1 mg/dl (ULN < 0.5)	156 mg/l (ULN < 3)
ECOG PS	0	0	1	1	2
Dosing	IPI1/NIVO3	IPI1/NIVO3	IPI1/NIVO3	IPI3/NIVO1	IPI3/NIVO1
Number of courses	4	1	4	4	2
BOR (RECIST 1.1)	CR	PD	PR	PR	PD
irAE	Fatigue °I	–	–	–	–
Maintenance therapy (NIVO)	No	No	No	Yes	No
PFS (months)	12.2	0.5	> 3.3	> 1.7	0.9
OS (months)	> 15.9	1.1	> 4.0	> 3.4	1.4
Progressed?	Yes	na	No	No	na
Alive?	Yes	no	Yes	Yes	No

MCC Merkel cell carcinoma; UICC Union international contre le cancer; MCPyV Merkel cell polyomavirus; BOR best overall response; irAE immune-related adverse event; LDH Lactate dehydrogenase; CRP C-reactive protein; ECOG PS Eastern Cooperative Oncology Group Performance Status; PFS progression-free survival; OS overall survival; na not applicable; PD progressive disease; SD stable disease; PR partial remission; CR complete response PNP peripheral polyneuropathy; IPI1/NIVO3 ipilimumab 1 mg per kg + nivolumab 3 mg per kg; IPI3/NIVO1 ipilimumab 3 mg per kg + nivolumab 1 mg per kg

^*Carboplatin + etoposide

^**Cisplatin + etoposide