New institute musters forces against lethal skin cancer

The Merkel Cell Carcinoma Collaborative Institute, the world’s only such entity focused on the rare, aggressive skin cancer, was launched this week at the University of Washington School of Medicine.   

Dubbed “MC3,” the institute emerged with the restructuring of programs of patient care, training and research that straddle the Fred Hutch Cancer Center, the UW Medicine Department of Dermatology, and the lab of its chair, Dr. Paul Nghiem, an expert on the disease.  

“Twenty years ago, I started a lab with three people. That’s grown to 25 or more,” said Nghiem, a professor of dermatology. “We directly and indirectly take care of people around the world. We developed two blood tests that have become standard for determining whether someone’s cancer is returning. We get patients into research trials. Our website’s simple language educates doctors and patients. We collaborate with dozens of labs worldwide. Forming an institute made sense.”  

Merkel cell carcinoma’s incidence varies globally. In the United States, projections are for nearly 3,300 new cases this year, according to a 2018 study led by Nghiem and colleagues. Prior to the availability of immunotherapy, the disease was fatal in more than one-third of cases. Today that figure is estimated to be 15-20% of cases, according to research from the MC3 team (publication pending). 

MC3 today has about 50 members, representing 15 institutions. Members have access to repositories of more than 60,000 biological specimens and a database with granular clinical details of 1,900-plus patients.   

Nghiem envisions that the institute will award pilot grants to member research labs that otherwise lack funding, and be a virtual meeting place that encourages member labs to collaborate on studies.   

MC3 staff also will train graduates and undergrads:  

• Both doctors and medical students can apply for a fellowship, which offers clinical research training programs of one to two years. The role entails managing upward of 100 patient-care inquiries a week and co-leading a multidisciplinary tumor board that discusses complex cases and generates treatment recommendations for patients around the world. 
• In an undergrad research program, UW students learn fundamentals of clinical research. This year, more than 300 students applied for three positions. 

Over the past two decades, Nghiem and Fred Hutch clinician-researchers have led studies that resulted in significantly better understanding of Merkel cell cancer’s molecular mechanisms. In turn, these discoveries have spurred new treatments to stimulate anti-tumor immune responses and reduce the likelihood of recurrence among patients.  

With new immune therapies, patients with advanced MCC have seen their chance of lasting benefit increase by tenfold, from 5% to 50%, Nghiem said.  

“The two highly sensitive blood tests we established for MCC can help clinicians detect recurrences months or years before the cancer can be found on a scan,” he added.  

These research advances have drawn patients from around the world to Seattle for treatment of Merkel cell carcinoma.  

Related: Merkelcell.org, launched in 2003 by Nghiem, teaches patients and physicians about the disease, clinical trials and the location of specialists.  

For details about UW Medicine, please visit http://uwmedicine.org/about.