FIGURE 1.

Clinical response with avelumab and radiotherapy after disease progression with avelumab. Positron emission tomography‐computed tomography scans of a 72‐year‐old male patient with metastatic Merkel cell carcinoma (MCPyV status unknown), chronic arterial fibrillation and paraneoplastic Lambert‐Eaton myasthenic syndrome, and a history of endocarditis with mitral valve replacement: (A) at baseline (January 2018); (B) disease progression after 7 cycles of avelumab (May 2018); and (C) clinical response after 15 cycles of avelumab and concomitant radiotherapy (50 Gy at 2 Gy/fraction) (September 2018). At the last follow‐up (January 2021), the patient had an ongoing partial response after 45 cycles of avelumab. Images were provided by Prof Bechter