2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T8a2,Tertiary lymphoid structures (TLS) are ectopic lymphoid formations within or around tumours, emerging as important predictors of prognosis and response to immune checkpoint inhibitors (ICI) in various cancers. However, in Merkel cell carcinoma (MCC), the correlation between TLS and ICI response has not yet been evaluated. Furthermore, the criteria for assessing TLS maturity vary by report, and there is no unified consensus. In this study, we investigated the relationship between TLS and ICI responsiveness in MCC using spatial proteomics at the single-cell level. By comparing the spatial characteristics of TLS in ICI responders and non-responders, we also aimed to identify features related to functionality of TLS, distinct from the previously reported maturity of TLS. We analysed 24 TLSs from 13 MCC cases treated with the anti-PD-L1 antibody, avelumab, employing the PhenoCycler platform with 16 oligonucleotide-labeled antibodies. Infiltrating immune cells and tumour cells were phenotyped based on machine learning, and spatial single-cell analysis was performed, including cellular neighbourhood analysis and cell-cell correlation analysis. Our findings revealed that the number of TLS positively correlated with survival and ICI response (p=0.0274). The number of TLS observed within the tumour was significantly higher in responders than in non-responders (p=0.0043). Cellular neighbourhood analysis and cell-cell correlation analysis demonstrated that in functional TLS in responder cases, T cells infiltrated densely within B cell clusters, extending close to follicular dendritic cells, and CD4-positive T cells adjacent to CD8-positive T cells express PD1. In contrast, in non-responder TLS, although B cell density is high, T cells did not infiltrate into B cell cluster areas but instead resided in the peripheral areas. Furthermore, it was found that CD8-positive T cells and CD4-positive T cells approaching B cells expressed PD1. This study demonstrated a significant positive correlation between the number of TLS and ICI response in MCC. Additionally, our results suggest that the immune composition and spatial configuration within TLS may be important determinants of ICI efficacy.31:Tbb6,Abstract Background Tertiary lymphoid structures (TLS) are ectopic lymphoid formations within or around tumours, emerging as important predictors of prognosis and response to immune checkpoint inhibitors (ICI) in various cancers. However, in Merkel cell carcinoma (MCC), the correlation between TLS and ICI response has not yet been evaluated. Furthermore, the criteria for assessing TLS maturity vary by report, and there is no unified consensus. Objective In this study, we investigated the relationship between TLS and ICI responsiveness in MCC using spatial proteomics at the single-cell level. By comparing the spatial characteristics of TLS in ICI responders and non-responders, we also aimed to identify features related to functionality of TLS, distinct from the previously reported maturity of TLS. Methods We analysed 24 TLSs from 13 MCC cases treated with the anti-PD-L1 antibody, avelumab, employing the PhenoCycler platform with 16 oligonucleotide-labeled antibodies. Infiltrating immune cells and tumour cells were phenotyped based on machine learning, and spatial single-cell analysis was performed, including cellular neighbourhood analysis and cell-cell correlation analysis. Results Our findings revealed that the number of TLS positively correlated with survival and ICI response (p=0.0274). The number of TLS observed within the tumour was significantly higher in responders than in non-responders (p=0.0043). Cellular neighbourhood analysis and cell-cell correlation analysis demonstrated that in functional TLS in responder cases, T cells infiltrated densely within B cell clusters, extending close to follicular dendritic cells, and CD4-positive T cells adjacent to CD8-positive T cells express PD1. In contrast, in non-responder TLS, although B cell density is high, T cells did not infiltrate into B cell cluster areas but instead resided in the peripheral areas. Furthermore, it was found that CD8-positive T cells and CD4-positive T cells approaching B cells expressed PD1. Conclusions This study demonstrated a significant positive correlation between the number of TLS and ICI response in MCC. Additionally, our results suggest that the immune composition and spatial configuration within TLS may be important determinants of ICI efficacy. 32:T464,Among the 503 patients in the cohort (median [IQR] age at diagnosis, 70 [62-77] years; 40% female), 1402 tests were performed; 247 (49%) were seropositive. A total of 877 were falling or negative, 62 were rising, 317 were stable, and 146 were deferred. Median (IQR) follow-up was 4.2 (1.8-7.4) years. On average, antibody titers fell by half every 3 months among patients not experiencing a recurrence. After a falling or negative titer, the likelihood that a given patient would remain recurrence-free for 3 months was 99.3% (95% CI, 98.6%-99.8%). In contrast, after a single rising titer, the risk of recurrence over the next 3 months was 36% (95% CI, 22%-52%), increasing to 58% (95% CI, 40%-78%) by 12 months and 68% (95% CI, 48%-86%) by 24 months. A rising titer preceded clinical or radiographic evidence of recurrence in 57% of cases (20/35). The median (IQR) interval between a rising titer and clinical disease detection was 3.7 (1.1-7.5) months, with 90% of recurrences (18/20) occurring within 14 months of the rising titer. Recurrences and antibody titers were analyzed in 196 patients with multiple blood draws.33:T937,Merkel cell carcinoma (MCC) is typically caused by the Merkel cell polyomavirus (MCPyV) and recurs in 40% of patients. Half of patients with MCC produce antibodies to MCPyV oncoproteins, the titers of which rise with disease recurrence and fall after successful treatment. To assess the utility of MCPyV oncoprotein antibodies for early detection of first recurrence of MCC in a real-world clinical setting. This prospective cohort study used a data and specimen repository from 2008 to 2020 in Seattle, Washington. Patients with MCC with locoregional disease underwent serum antibody testing at diagnosis. Statistical analysis was conducted between 2020 and 2025. The first posttreatment titer was necessary to establish a trend and was not used to assess risk (deferred). Subsequent titers were defined as (1) falling or negative, (2) rising, or (3) stable compared with the preceding titer. Among the 503 patients in the cohort (median [IQR] age at diagnosis, 70 [62-77] years; 40% female), 1402 tests were performed; 247 (49%) were seropositive. A total of 877 were falling or negative, 62 were rising, 317 were stable, and 146 were deferred. Median (IQR) follow-up was 4.2 (1.8-7.4) years. On average, antibody titers fell by half every 3 months among patients not experiencing a recurrence. After a falling or negative titer, the likelihood that a given patient would remain recurrence-free for 3 months was 99.3% (95% CI, 98.6%-99.8%). In contrast, after a single rising titer, the risk of recurrence over the next 3 months was 36% (95% CI, 22%-52%), increasing to 58% (95% CI, 40%-78%) by 12 months and 68% (95% CI, 48%-86%) by 24 months. A rising titer preceded clinical or radiographic evidence of recurrence in 57% of cases (20/35). The median (IQR) interval between a rising titer and clinical disease detection was 3.7 (1.1-7.5) months, with 90% of recurrences (18/20) occurring within 14 months of the rising titer. Recurrences and antibody titers were analyzed in 196 patients with multiple blood draws. In this prospective cohort study, given a negative predictive value of 99.3%, a falling or negative titer may obviate the need for imaging, reducing radiation and contrast dye exposure. Conversely, a rising antibody titer should trigger closer follow-up, as it may lead to earlier detection of clinical recurrence and initiation of therapy.34:Td5f, Importance Merkel cell carcinoma (MCC) is typically caused by the Merkel cell polyomavirus (MCPyV) and recurs in 40% of patients. Half of patients with MCC produce antibodies to MCPyV oncoproteins, the titers of which rise with disease recurrence and fall after successful treatment. Objective To assess the utility of MCPyV oncoprotein antibodies for early detection of first recurrence of MCC in a real-world clinical setting. Design, Setting, and Participants This prospective cohort study used a data and specimen repository from 2008 to 2020 in Seattle, Washington. Patients with MCC with locoregional disease underwent serum antibody testing at diagnosis. Statistical analysis was conducted between 2020 and 2025. Main Outcomes and Measures The first posttreatment titer was necessary to establish a trend and was not used to assess risk (deferred). Subsequent titers were defined as (1) falling or negative, (2) rising, or (3) stable compared with the preceding titer. Results Among the 503 patients in the cohort (median [IQR] age at diagnosis, 70 [62-77] years; 40% female), 1402 tests were performed; 247 (49%) were seropositive. A total of 877 were falling or negative, 62 were rising, 317 were stable, and 146 were deferred. Median (IQR) follow-up was 4.2 (1.8-7.4) years. On average, antibody titers fell by half every 3 months among patients not experiencing a recurrence. After a falling or negative titer, the likelihood that a given patient would remain recurrence-free for 3 months was 99.3% (95% CI, 98.6%-99.8%). In contrast, after a single rising titer, the risk of recurrence over the next 3 months was 36% (95% CI, 22%-52%), increasing to 58% (95% CI, 40%-78%) by 12 months and 68% (95% CI, 48%-86%) by 24 months. A rising titer preceded clinical or radiographic evidence of recurrence in 57% of cases (20/35). The median (IQR) interval between a rising titer and clinical disease detection was 3.7 (1.1-7.5) months, with 90% of recurrences (18/20) occurring within 14 months of the rising titer. Recurrences and antibody titers were analyzed in 196 patients with multiple blood draws. Conclusions and Relevance In this prospective cohort study, given a negative predictive value of 99.3%, a falling or negative titer may obviate the need for imaging, reducing radiation and contrast dye exposure. Conversely, a rising antibody titer should trigger closer follow-up, as it may lead to earlier detection of clinical recurrence and initiation of therapy. 35:T9ef,Merkel cell carcinoma (MCC) is a rare cutaneous malignant neoplasm with increasing incidence and high mortality. Although it is accepted that the optimal treatment for localized tumors is surgical, the data surrounding the optimal surgical approach are mixed, and current National Comprehensive Cancer Network guidelines state that Mohs micrographic surgery (MMS) and wide local excision (WLE) can both be used. The current National Comprehensive Cancer Network guidelines do not advocate a preference for MMS or WLE and suggest that they can be used interchangeably. To evaluate the association of surgical approach with overall survival after excision of localized T1/T2 MCC. This retrospective cohort study used the National Cancer Database to assess adults with T1/T2 MCC who were diagnosed between January 1, 2004, and December 31, 2018, with pathologically confirmed, negative regional lymph nodes and treated with surgery. The National Cancer Database includes all reportable cases from Commission on Cancer-accredited facilities. Data analysis was performed from October 2022 to May 2023. Surgical approach. Overall survival. A total of 2313 patients (mean [SD] age, 71 [10.6] years; 1340 [57.9%] male) were included in the study. Excision with MMS had the best unadjusted survival, with mean (SE) survival rates of 87.4% (3.4%) at 3 years, 84.5% (3.9%) at 5 years, and 81.8% (4.6%) at 10 years vs 86.1% (0.9%) at 3 years, 76.9% (1.2%) at 5 years, and 60.9% (2.0%) at 10 years for patients treated with WLE. Patients treated with narrow-margin excision had similar survival as those treated with WLE, with mean (SE) survival rates of 84.8% (1.4%) at 3 years, 78.3% (1.7%) at 5 years, and 60.8% (3.6%) at 10 years. On multivariable survival analysis, excision with MMS was associated with significantly improved survival compared with WLE (hazard ratio, 0.59; 95% CI, 0.36-0.97; P = .04). High-volume MCC centers were significantly more likely to use MMS over WLE compared with other centers (odds ratio, 1.99; 95% CI, 1.63-2.44; P < .001). In this cohort study, the use of MMS (compared with WLE) was associated with significantly improved survival for patients with localized MCC with pathologically confirmed negative lymph nodes treated with surgery. These data suggest that Mohs surgery may provide a more effective treatment for MCC primary tumors than conventional WLE, although the lack of randomization and potential for selection bias in this study highlight the need for future prospective work evaluating this issue.36:Tce8,ImportanceMerkel cell carcinoma (MCC) is a rare cutaneous malignant neoplasm with increasing incidence and high mortality. Although it is accepted that the optimal treatment for localized tumors is surgical, the data surrounding the optimal surgical approach are mixed, and current National Comprehensive Cancer Network guidelines state that Mohs micrographic surgery (MMS) and wide local excision (WLE) can both be used. The current National Comprehensive Cancer Network guidelines do not advocate a preference for MMS or WLE and suggest that they can be used interchangeably.ObjectiveTo evaluate the association of surgical approach with overall survival after excision of localized T1/T2 MCC.Design, Setting, and ParticipantsThis retrospective cohort study used the National Cancer Database to assess adults with T1/T2 MCC who were diagnosed between January 1, 2004, and December 31, 2018, with pathologically confirmed, negative regional lymph nodes and treated with surgery. The National Cancer Database includes all reportable cases from Commission on Cancer–accredited facilities. Data analysis was performed from October 2022 to May 2023.ExposureSurgical approach.Main Outcomes and MeasuresOverall survival.ResultsA total of 2313 patients (mean [SD] age, 71 [10.6] years; 1340 [57.9%] male) were included in the study. Excision with MMS had the best unadjusted survival, with mean (SE) survival rates of 87.4% (3.4%) at 3 years, 84.5% (3.9%) at 5 years, and 81.8% (4.6%) at 10 years vs 86.1% (0.9%) at 3 years, 76.9% (1.2%) at 5 years, and 60.9% (2.0%) at 10 years for patients treated with WLE. Patients treated with narrow-margin excision had similar survival as those treated with WLE, with mean (SE) survival rates of 84.8% (1.4%) at 3 years, 78.3% (1.7%) at 5 years, and 60.8% (3.6%) at 10 years. On multivariable survival analysis, excision with MMS was associated with significantly improved survival compared with WLE (hazard ratio, 0.59; 95% CI, 0.36-0.97; P = .04). High-volume MCC centers were significantly more likely to use MMS over WLE compared with other centers (odds ratio, 1.99; 95% CI, 1.63-2.44; P &lt; .001).Conclusions and RelevanceIn this cohort study, the use of MMS (compared with WLE) was associated with significantly improved survival for patients with localized MCC with pathologically confirmed negative lymph nodes treated with surgery. These data suggest that Mohs surgery may provide a more effective treatment for MCC primary tumors than conventional WLE, although the lack of randomization and potential for selection bias in this study highlight the need for future prospective work evaluating this issue.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Merkel Cell Carcinoma: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Merkel Cell Carcinoma (condition). 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Adding antibody testing to ctDNA identified only 1 additional recurrence beyond ctDNA alone across 32 patients with recurrence.","limitations":"- Only patients with detectable MCPyV antibodies at diagnosis were included, so findings may not apply to virus-negative (MCPyV-negative) MCC.\n- Median follow-up was ~16 months; longer-term performance is unknown.\n- Study limited to academic centers, which may limit generalizability to community settings.","practice_takeaway":"For MCC patients with detectable MCPyV antibodies, ctDNA is a more reliable surveillance biomarker than antibody testing — consider prioritizing ctDNA for routine recurrence monitoring. Adding antibody testing on top of ctDNA provides minimal incremental value."}},{"doi":"10.1016/j.jid.2026.04.045","pmid":"42302921","title":"Mouse model of Merkel cell carcinoma derived from the hair follicle","journal_title":"Journal of Investigative Dermatology","journal_issn":"0022-202X","published_at":"2026-06-16T00:00:00.000Z","url":"https://doi.org/10.1016/j.jid.2026.04.045","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:47.761Z","updated_at":"2026-06-27T13:27:47.761Z","tags":[{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"condition","value":"Merkel Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"condition","value":"Neuroendocrine Skin Cancer","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"generic","value":"Merkel cell polyomavirus small T antigen","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"modality","value":"Viral Oncogene Expression (MCPyV T Antigens)","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"study_design","value":"Animal Model Study","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"warning","value":"Age group tag reflects mouse model context — not applicable to a human patient population.","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"warning","value":"Large T antigen (LT-Ag) role in tumor initiation was not directly tested in this model despite its known importance in MCC.","value_numeric":null},{"paper_doi":"10.1016/j.jid.2026.04.045","tag_type":"warning","value":"Study is entirely preclinical (mouse model); no human subjects or clinical outcomes are reported.","value_numeric":null}],"summaries":{"what_studied":"This study developed a mouse model of Merkel cell carcinoma (MCC) by expressing Merkel cell polyomavirus small T antigen (sT-Ag) and suppressing Trp53 specifically in SOX9+ hair follicle progenitor cells, to investigate MCC cell of origin and tumor initiation.","key_result":"sT-Ag expression combined with Trp53 attenuation in SOX9+ hair follicle cells produced metastatic neuroendocrine tumors recapitulating the histopathologic and immunophenotypic features of human MCC; sT-Ag alone induced partial MCC-associated gene expression but p53 suppression was required for full neuroendocrine lineage transdifferentiation.","limitations":"This is a mouse model and may not fully recapitulate human MCC biology; the study does not directly test the role of the large T antigen (LT-Ag) in tumor initiation; findings are limited to SOX9+ hair follicle progenitors and do not rule out other cells of origin.","practice_takeaway":"This immunocompetent de novo MCC mouse model provides a platform for preclinical testing of MCC therapies and offers mechanistic insight into the cooperative roles of viral T antigens and p53 loss in MCC initiation — but direct clinical application awaits further translational studies."}},{"doi":"10.1053/j.ajkd.2026.01.011","pmid":"42167833","title":"Malignancy and Kidney Transplant: Core Curriculum 2026","journal_title":"American Journal of Kidney Diseases","journal_issn":"0272-6386","published_at":"2026-05-20T00:00:00.000Z","url":"https://doi.org/10.1053/j.ajkd.2026.01.011","source_score":24,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-03T13:44:31.911Z","updated_at":"2026-06-03T13:44:31.911Z","tags":[{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"brand","value":"Opdivo","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"AL Amyloidosis","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Cutaneous Squamous Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Kidney Transplantation","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Melanoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Merkel Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Multiple Myeloma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Plasma Cell Dyscrasia","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Posttransplant Lymphoproliferative Disorder","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"condition","value":"Renal Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"acitretin","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"azathioprine","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"belzutifan","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"cemiplimab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"daratumumab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"ipilimumab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"lenalidomide","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"mycophenolate mofetil","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"nivolumab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"sirolimus","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"generic","value":"tacrolimus","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Anti-CD38 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Calcineurin Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"CAR-T Cell Therapy","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"mTOR Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Oncolytic Virus Therapy","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Proteasome Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"modality","value":"Tyrosine Kinase Inhibitor","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"study_design","value":"Review Article / Core Curriculum","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"Emerging therapies (oncolytic virus, EBV-VST, CAR-T in transplant) are discussed based on early-phase or limited case data and should not be considered standard of care.","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"ICI rejection risk figures (25–42%) are pooled from retrospective cohorts with heterogeneous IS reduction practices, limiting direct applicability.","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"Sample size tag omitted as no single study population is defined across this multi-topic review.","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.01.011","tag_type":"warning","value":"This is a narrative Core Curriculum review, not a primary research study; evidence grades vary widely by topic and most recommendations are expert consensus or based on observational data.","value_numeric":null}],"summaries":{"what_studied":"This Core Curriculum reviews cancer risk, screening, and management in kidney transplant candidates and recipients (KTRs), covering skin cancers, PTLD, plasma cell dyscrasias, and solid tumors, with emphasis on immunosuppression (IS) management and emerging therapies including immune checkpoint inhibitors (ICIs) and CAR-T cells.","key_result":"KTRs face 2–4× higher overall cancer risk vs. the general population; skin cancer SIRs reach 65–250 (cSCC) and 13–24 (Merkel cell); DLBCL is 8× more common; kidney cancer is 7× more common. ICI use carries ~25–42% acute rejection risk; patients on corticosteroids + mTOR inhibitors had lower rejection (HR 0.30). Median overall survival after transplant was 8.4 years for myeloma and 8.6 years for AL amyloidosis KTRs.","limitations":"Most recommendations are based on expert consensus, observational data, and case series rather than RCTs; ICI safety/efficacy data in KTRs come largely from retrospective analyses; screening benefit on long-term mortality in KTRs remains unproven.","practice_takeaway":"Convert azathioprine to mycophenolate or switch to an mTOR inhibitor for KTRs with recurrent non-melanoma skin cancers; minimize IS (remove antimetabolites first) when initiating ICI, and treat ICI-associated rejection with pulse steroids rather than antithymocyte globulin to preserve antitumor response. Cervical cancer screening should be more frequent (every 6–12 months) after transplant, and IMiDs should be stopped ≥4 weeks before kidney transplant in myeloma patients."}},{"doi":"10.1001/jamadermatol.2026.0355","pmid":"41920537","title":"Risk of Skin Cancer Among Patients With Chronic Lymphocytic Leukemia","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2026-04-01T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13044794/","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:00.987Z","updated_at":"2026-05-24T13:23:00.987Z","tags":[{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"condition","value":"Basal Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"condition","value":"Chronic Lymphocytic Leukemia","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"condition","value":"Cutaneous Lymphoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"condition","value":"Melanoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"condition","value":"Merkel Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"condition","value":"Squamous Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"sample_size","value":"n=50112","value_numeric":50112},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"study_design","value":"Matched Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"warning","value":"Full text is under PMC embargo until April 1, 2027; structured data are derived from the abstract and results sections only — details on CLL treatment subtypes and their individual contributions to skin cancer risk are not available.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"warning","value":"Sample size of n=50,112 reflects the combined CLL patients (8,352) plus controls (41,760); tagged accordingly.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0355","tag_type":"warning","value":"The study did not report sex-stratified skin cancer risk estimates; the 'mixed' sex tag reflects overall cohort composition (~59% male).","value_numeric":null}],"summaries":{"what_studied":"This nationwide population-based matched cohort study (Denmark, 1990–2020) assessed the 10-year risk of skin cancer, skin cancer subtypes, metastasis, and skin cancer-specific death in 8,352 CLL patients compared with 41,760 matched controls (1:5 ratio), excluding those with prior skin cancer or immunosuppression.","key_result":"The 10-year absolute risk of any skin cancer was 13.5% in CLL patients vs. 6.9% in controls (ARD +6.6 pp). BCC (ARD +3.2 pp) and SCC (ARD +3.3 pp) drove most of the excess. Skin cancer metastasis (0.7% vs. 0.1%, ARD +0.6 pp) and skin cancer-specific death (0.3% vs. 0.1%, ARD +0.2 pp) were also significantly higher in CLL patients, though absolute risks remained low against a backdrop of 56.3% all-cause mortality.","limitations":"- Study is observational; residual confounding (e.g., UV exposure, sun-protective behaviors) cannot be excluded.\n- Full-text not available for review; data drawn from abstract and results only.\n- Danish registry data may limit generalizability to other populations or healthcare systems.","practice_takeaway":"Clinicians managing CLL patients should proactively screen for skin cancer, particularly BCC and SCC, given roughly double the baseline risk compared to matched controls. While metastasis and skin cancer death risks are elevated, they remain low in absolute terms relative to CLL's high overall mortality."}},{"doi":"10.1093/bjd/ljaf525","pmid":"41466351","title":"Spatial Proteomics of Tertiary Lymphoid Structures Reveals Correlation with Immunotherapy Response in Merkel Cell Carcinoma","journal_title":"British Journal of Dermatology","journal_issn":"0007-0963","published_at":"2025-12-30T00:00:00.000Z","url":"https://doi.org/10.1093/bjd/ljaf525","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-12-31","doi":"10.1093/bjd/ljaf525","days":"14","issn":"0007-0963","rank":"9","field":"Clinical Medicine","score":"7","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1093/bjd/ljaf525","title":"Spatial Proteomics of Tertiary Lymphoid Structures Reveals Correlation with Immunotherapy Response in Merkel Cell Carcinoma.","journal":"The British journal of dermatology","methods":"","results":"Our findings revealed that the number of TLS positively correlated with survival and ICI response (p=0.0274). The number of TLS observed within the tumour was significantly higher in responders than in non-responders (p=0.0043). Cellular neighbourhood analysis and cell-cell correlation analysis demonstrated that in functional TLS in responder cases, T cells infiltrated densely within B cell clusters, extending close to follicular dendritic cells, and CD4-positive T cells adjacent to CD8-positive T cells express PD1. In contrast, in non-responder TLS, although B cell density is high, T cells did not infiltrate into B cell cluster areas but instead resided in the peripheral areas. Furthermore, it was found that CD8-positive T cells and CD4-positive T cells approaching B cells expressed PD1.","abstract":"$30","keywords":[],"pubmed_id":"41466351","conclusions":"","publication_date":"2025-12-30T00:00:00"},"crossref":{"DOI":"10.1093/bjd/ljaf525","URL":"https://doi.org/10.1093/bjd/ljaf525","ISSN":["0007-0963","1365-2133"],"link":[{"URL":"https://academic.oup.com/bjd/advance-article-pdf/doi/10.1093/bjd/ljaf525/66149984/ljaf525.pdf","content-type":"application/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https://academic.oup.com/bjd/advance-article-pdf/doi/10.1093/bjd/ljaf525/66149984/ljaf525.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Spatial Proteomics of Tertiary Lymphoid Structures Reveals Correlation with Immunotherapy Response in Merkel Cell Carcinoma"],"author":[{"given":"Motoki","family":"Nakamura","sequence":"first","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences"}]},{"given":"Dai","family":"Ogata","sequence":"additional","affiliation":[{"name":"Department of Dermatologic Oncology, National Cancer Center Hospital"}]},{"given":"Junji","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sapporo Medical University School of Medicine"}]},{"given":"Yi-Wen","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences"}]},{"given":"Jiayue","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical 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of Medical Sciences"}]},{"given":"Takeo","family":"Maekawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Jichi Medical University Saitama Medical Center"}]},{"given":"Masahito","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Gunma University Graduate School of Medicine"}]},{"given":"Yukiko","family":"Kiniwa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shinshu University"}]},{"given":"Hideyuki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Environment Immuno-Dermatology, Yokohama City University"}]},{"given":"Yasuhiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center"}]},{"given":"Kotaro","family":"Nagase","sequence":"additional","affiliation":[{"name":"Nagase Dermatology Clinic"},{"name":"Department of Dermatology, Fukuoka 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University Press (OUP)","reference":null,"short-title":[],"article-number":"ljaf525","content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["British Journal of Dermatology"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2025,12,29]]},"references-count":0,"short-container-title":[],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1093/bjd/ljaf525","is_oa":false,"title":"Spatial Proteomics of Tertiary Lymphoid Structures Reveals Correlation with Immunotherapy Response in Merkel Cell Carcinoma","updated":"2026-01-01T00:56:08+00:00","published_date":"2025-12-25","best_oa_location":null}},"created_at":"2026-01-11T11:19:33.869Z","updated_at":"2026-01-11T11:19:33.869Z","tags":[{"paper_doi":"10.1093/bjd/ljaf525","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1093/bjd/ljaf525","tag_type":"condition","value":"Merkel Cell 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16-antibody panel) characterized 24 tertiary lymphoid structures from 13 Merkel cell carcinoma cases treated with the PD‑L1 inhibitor avelumab, comparing responders vs non-responders and relating TLS number and spatial features to survival and ICI response.","key_result":"TLS count positively correlated with survival and ICI response (p=0.0274); responders had more intratumoral TLS than non-responders (p=0.0043). In responders, T cells densely infiltrated B‑cell clusters and approached follicular dendritic cells, with adjacent CD4 and CD8 T cells expressing PD1; in non-responders, T cells remained peripheral to B‑cell clusters."}},{"doi":"10.1001/jamadermatol.2025.3155","pmid":"40928768","title":"Polyomavirus Antibodies for Merkel Cell Carcinoma Recurrence Detection","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-09-10T00:00:00.000Z","url":"https://doi.org/10.1001/jamadermatol.2025.3155","source_score":20,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-11-21","doi":"10.1001/jamadermatol.2025.3155","days":"14","issn":"2168-6068","rank":"7","field":"Clinical Medicine","score":"20","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.3155","title":"Polyomavirus Antibodies for Merkel Cell Carcinoma Recurrence Detection.","journal":"JAMA 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The first posttreatment titer was deferred; subsequent titers were classified as falling/negative, rising, or stable.","key_result":"Among 1402 tests, titers fell by half every 3 months in patients without recurrence. After a falling/negative titer, the 3‑month probability of remaining recurrence‑free was 99.3% (95% CI, 98.6%-99.8%), whereas a single rising titer carried a 36% risk of recurrence at 3 months (95% CI, 22%-52%), 58% at 12 months (95% CI, 40%-78%), and 68% at 24 months (95% CI, 48%-86%); rising titers preceded clinical or radiographic recurrence in 57% (20/35), with a median lead time of 3.7 months (IQR, 1.1-7.5).","limitations":"Only 49% (247/503) were seropositive, so antibody monitoring applies to a subset of patients. Recurrence and titer dynamics were analyzed in 196 patients with multiple blood draws, smaller than the full cohort. The cohort derives from a single‑region repository in Seattle.","practice_takeaway":"For seropositive MCC, a falling or negative MCPyV oncoprotein antibody titer has a 99.3% 3‑month negative predictive value and may allow deferring imaging. A rising titer should prompt closer follow‑up to enable earlier detection and treatment of recurrence."}},{"doi":"10.1001/jamadermatol.2023.2822","pmid":"37610773","title":"Overall Survival After Mohs Surgery for Early-Stage Merkel Cell Carcinoma","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2023-08-23T00:00:00.000Z","url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10448369","source_score":63,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2023-11-15","doi":"10.1001/jamadermatol.2023.2822","days":"30","issn":"2168-6068","rank":"4","field":"Clinical Medicine","score":"63","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2023.2822","title":"Overall Survival After Mohs Surgery for Early-Stage Merkel Cell Carcinoma.","journal":"JAMA dermatology","methods":"","results":"A total of 2313 patients (mean [SD] age, 71 [10.6] years; 1340 [57.9%] male) were included in the study. Excision with MMS had the best unadjusted survival, with mean (SE) survival rates of 87.4% (3.4%) at 3 years, 84.5% (3.9%) at 5 years, and 81.8% (4.6%) at 10 years vs 86.1% (0.9%) at 3 years, 76.9% (1.2%) at 5 years, and 60.9% (2.0%) at 10 years for patients treated with WLE. Patients treated with narrow-margin excision had similar survival as those treated with WLE, with mean (SE) survival rates of 84.8% (1.4%) at 3 years, 78.3% (1.7%) at 5 years, and 60.8% (3.6%) at 10 years. On multivariable survival analysis, excision with MMS was associated with significantly improved survival compared with WLE (hazard ratio, 0.59; 95% CI, 0.36-0.97; P = .04). High-volume MCC centers were significantly more likely to use MMS over WLE compared with other centers (odds ratio, 1.99; 95% CI, 1.63-2.44; P < .001).","abstract":"$35","keywords":[],"pubmed_id":"37610773","conclusions":"","publication_date":"2023-08-23T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2023.2822","URL":"https://doi.org/10.1001/jamadermatol.2023.2822","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2808884/jamadermatology_cheraghlou_2023_oi_230036_1697555524.75181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1068","type":"journal-article","issue":"10","score":1,"title":["Overall Survival After Mohs Surgery for Early-Stage Merkel Cell Carcinoma"],"author":[{"given":"Shayan","family":"Cheraghlou","sequence":"first","affiliation":[{"name":"The Ronald O. 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In multivariable analysis, MMS was associated with lower mortality than WLE (HR 0.59; 95% CI 0.36–0.97; P=0.04), narrow‑margin excision was similar to WLE, and high‑volume centers were more likely to use MMS (OR 1.99; 95% CI 1.63–2.44).","limitations":"Nonrandomized, retrospective NCDB analysis with potential selection bias. Treatment selection varied by center volume, which could confound results.","practice_takeaway":"For localized, node‑negative T1/T2 Merkel cell carcinoma, MMS was associated with better overall survival than WLE in this large cohort; consider this signal when planning surgery, while awaiting prospective confirmation."}}],"initialOffset":7,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Merkel Cell Carcinoma"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Merkel Cell Carcinoma"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Merkel Cell Carcinoma"}}}]]

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