Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a high risk of metastasis. The development of anti-PD-1/PD-L1 immunotherapy has improved outcomes for advanced MCC, yet about 50% of such patients do not achieve durable responses. This study analyzed the effects of age and body mass index (BMI) on immunotherapy response in 183 advanced MCC patients from a single-center longitudinal database. Using Fine–Gray or Cox regression models, treatment response, progression-free survival (PFS), MCC-specific survival, and overall survival (OS) were evaluated. Age showed a significant non-linear relationship with treatment response (p= 0.04), with patients much older or younger than 70 years less likely to respond. However, age was not significantly associated with PFS (p= 0.21), MCC-specific survival (p= 0.72), or OS (p= 0.36). Similarly, BMI was not significantly correlated with treatment response (p= 0.41), PFS (p= 0.52), MCC-specific survival (p= 0.78), or OS (p= 0.71). Unlike previous studies suggesting that obesity and advanced age improve outcomes in other cancers, these associations were not observed in MCC. These findings suggest that age and BMI should not influence eligibility for immunotherapy in MCC patients, emphasizing the importance of unbiased patient selection for this treatment.
默克尔细胞癌是一种罕见且具有侵袭性的皮肤癌，转移风险较高。抗PD-1/PD-L1免疫疗法的应用改善了晚期默克尔细胞癌的治疗效果，但约50%的此类患者未能获得持久应答。本研究基于单中心纵向数据库，对183例晚期默克尔细胞癌患者进行分析，探讨年龄与体重指数对免疫治疗应答的影响。通过Fine-Gray或Cox回归模型评估治疗应答率、无进展生存期、默克尔细胞癌特异性生存期及总生存期。年龄与治疗应答呈显著非线性关系（p=0.04），年龄显著高于或低于70岁的患者应答可能性较低。然而，年龄与无进展生存期（p=0.21）、默克尔细胞癌特异性生存期（p=0.72）及总生存期（p=0.36）均无显著关联。同样，体重指数与治疗应答（p=0.41）、无进展生存期（p=0.52）、默克尔细胞癌特异性生存期（p=0.78）及总生存期（p=0.71）均无显著相关性。与既往研究提示肥胖和高龄可改善其他癌症预后的结论不同，本研究在默克尔细胞癌中未观察到此类关联。这些发现表明，年龄和体重指数不应作为默克尔细胞癌患者免疫治疗资格的限制因素，强调了在该治疗中保持患者选择客观性的重要意义。
肿瘤(癌症)患者之家