{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:56:41Z","timestamp":1790193401514,"version":"4.1.0"},"reference-count":27,"publisher":"Harborside Press, LLC","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The role of adjuvant immunotherapy (IO) in the treatment of Merkel cell carcinoma (MCC) is currently being explored in clinical trials. Here we aim to evaluate the real-world impact of adjuvant IO on survival in patients with MCC.\n                    <jats:bold>Methods:<\/jats:bold>\n                    A retrospective analysis of the National Cancer Database was performed to identify patients with stage I\u2013III MCC. Our main predictor of interest was IO in an adjuvant setting, stratified by receipt of radiotherapy (RT). A multivariable Cox proportional hazards regression model with inverse probability treatment weighting was used to estimate overall survival.\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 353 patients received adjuvant IO, while 5,340 underwent surgery without adjuvant therapy. Among patients who received adjuvant IO, 10.2% had stage I disease, 7.1% stage II, and 82.7% stage III. Overall, adjuvant IO was not associated with a difference in survival (hazard ratio [HR], 1.04; 95% CI, 0.86\u20131.26). Stratified analyses by stage demonstrated similar findings (stage I: HR, 1.4; 95% CI, 0.79\u20132.50; stage II: HR, 1.45; 95% CI, 0.67\u20133.13; stage III: HR, 0.98; 95% CI, 0.79\u20131.20). However, when an interaction term with RT was introduced with adjuvant IO, both treatments were associated with improved survival compared with surgery alone (HR, 0.53; 95% CI, 0.28\u20130.99), whereas adjuvant IO without RT was not associated with a significant survival difference (HR, 1.14; 95% CI, 0.83\u20131.60).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    The association between adjuvant IO on survival may be modified by RT, which should be considered when interpreting current adjuvant IO trials in MCC.\n                  <\/jats:p>","DOI":"10.6004\/jnccn.2026.7018","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T19:03:51Z","timestamp":1782241431000},"source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the Impact of Adjuvant Immunotherapy in Merkel Cell Carcinoma"],"prefix":"10.6004","volume":"24","author":[{"given":"Bryant","family":"Morocho","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Roger Williams Medical Center, Providence, RI"},{"name":"Roger Williams Surgery and Cancer Outcomes Research and Equity (RWSCORE) Center, Roger Williams Medical Center, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Lightfoot","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Roger Williams Medical Center, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Saied","family":"Calvino","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Roger Williams Medical Center, Providence, RI"},{"name":"Roger Williams Surgery and Cancer Outcomes Research and Equity (RWSCORE) Center, Roger Williams Medical Center, Providence, RI"},{"name":"Department of Surgery, Boston University School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ponnandai","family":"Somasundar","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Roger Williams Medical Center, Providence, RI"},{"name":"Roger Williams Surgery and Cancer Outcomes Research and Equity (RWSCORE) Center, Roger Williams Medical Center, Providence, RI"},{"name":"Department of Surgery, Boston University School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Roger Williams Medical Center, Providence, RI"},{"name":"Roger Williams Surgery and Cancer Outcomes Research and Equity (RWSCORE) Center, Roger Williams Medical Center, Providence, RI"},{"name":"Department of Surgery, Boston University School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","article-title":"Merkel cell carcinoma of the skin","author":"Brady M","unstructured":"Brady M, Puckett Y. 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Radiotherapy combined with immunotherapy: the dawn of cancer treatment. Signal Transduct Target Ther 2022;7:258."},{"key":"B26","series-title":"J Geriatr Oncol","first-page":"1340","article-title":"Adverse events, need for hospitalization and systemic immunosuppression in very older patients (over 80 years) treated with anti-PD-1 for metastatic melanoma","volume":"11","author":"Barailler H","year":"2020","unstructured":"Barailler H, Salomon G, Dutriaux C,  Adverse events, need for hospitalization and systemic immunosuppression in very older patients (over 80 years) treated with anti-PD-1 for metastatic melanoma. J Geriatr Oncol 2020;11:1340\u20131343."},{"key":"B27","series-title":"Cancer","first-page":"1904","article-title":"Immune checkpoint inhibitors in challenging populations","volume":"123","author":"Johnson DB","year":"2017","unstructured":"Johnson DB, Sullivan RJ, Menzies AM. Immune checkpoint inhibitors in challenging populations. Cancer 2017;123:1904\u20131911."}],"container-title":["Journal of the National Comprehensive Cancer Network"],"original-title":[],"link":[{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/24\/8\/article-e267018.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/24\/8\/article-e267018.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/24\/8\/article-e267018.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:56:10Z","timestamp":1786971370000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/24\/8\/article-e267018.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":27,"journal-issue":{"issue":"8"},"URL":"https:\/\/doi.org\/10.6004\/jnccn.2026.7018","relation":{},"ISSN":["1540-1405","1540-1413"],"issn-type":[{"value":"1540-1405","type":"print"},{"value":"1540-1413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}