Disease Briefing

Merkel cell carcinoma: research and therapeutic landscape

A live synthesis of what is being targeted, what is being trialled, which datasets exist, and where the actionable gaps sit — assembled from public APIs, with every figure traceable to its source.

Generated 2026-09-17Sources Open Targets · ClinicalTrials.gov · openFDA · GEO · PubMed · Europe PMC · iCite · RePORTERRanked 53 studies · 2,144 GEO samples
Reading as
Reorders emphasis only — nothing is hidden or loaded on demand.

Answer block

12 genes recurrently implicated in Merkel cell carcinoma — TP53, RB1, CD274, PDCD1, PIK3CA, NOTCH1, KMT2D, MYCL, ATOH1, SOX2, NCAM1, LAG3 — triaged for what can actually be aimed at them, alongside the trials, public datasets, literature and funding around the disease. Every figure below carries its source and retrieval date in the section it comes from.

3
drugs carry an FDA label naming Merkel cell carcinoma: Avelumab, Pembrolizumab, Retifanlimab. This counts labels, not treatment — the disease is also treated with agents approved under broader indications
2
of the 12 genes above carry a drug that is approved in Merkel cell carcinoma itself — CD274, PDCD1. Across all of them 89 drug entries reach these genes, 87 distinct once salt forms are merged
4
registered polyomavirus T antigen cell-therapy trials in Merkel cell carcinoma, 1 active. Counted from ClinicalTrials.gov across 5 synonyms, deduplicated by NCT id, interventional studies only — the query is published in the JSON beside this page so the number can be re-derived
5
targets carry an Open Targets tractability signal and have no clinical programme of any kind: RB1, PIK3CA, NOTCH1, KMT2D, SOX2. CD274, PDCD1 have cell-therapy trials, so they are undrugged rather than untouched
103
human GEO series match the disease; 53 survive on-topic filtering, and only 1 are patient cohorts of 100+ samples
25
Europe PMC full-text papers name GSE39612 — the highest accession-mention count in the set. A mention is not proof of reanalysis, so read it as reach rather than reuse
$15.9M
NIH obligations in FY2025, up 104% since 2013 — while distinct core projects went 15 to 21. Both more projects (+40%) and larger awards, the latter carrying more of the growth; core projects are not the same unit as laboratories

Target landscape

Open Targets · retrieved 2026-09-17 · weekly

12 genes recurrently implicated in Merkel cell carcinoma, triaged for whether anything can actually be aimed at them. The zeros are the informative rows.

Of 12 recurrently implicated genes, 7 carry any drug at all. That is a statement about these 12 gene targets, not about the disease: Merkel cell carcinoma does have labelled therapy — 3 drugs, listed in the next section.

Two different questions

The table below asks what can be aimed at 12 recurrently implicated genes. That is narrower than what is approved for the disease, and narrower again than what Merkel cell carcinoma is actually treated with, which includes agents approved under broader indications. All three are on this page and they are kept apart deliberately.

GeneDrugsApproval, and whether it reached this diseaseOpen Targets tractabilitycomputed from protein features and literature — a signal that a modality is worth trying, not evidence that it worksCell therapy here
TP53 across cancers → 8 Phase 3Alrizomadlin, Cenersen, Contusugene Ladenovec, Eprenetapopt, Idasanutlin, Navtemadlin, Siremadlin, Teprasiran2 trials, none active other clinical modality, protein degrader, small molecule
RB1 across cancers → 0 No drug protein degrader, small molecule
CD274 across cancers → 13 5 approvedAtezolizumab, Avelumab, Cosibelimab, Durvalumab, SugemalimabApproved in Merkel cell carcinoma: Avelumab.14 active of 45 Merkel cell carcinoma trials antibody, other clinical modality, protein degrader, small molecule 0 active of 2 trials
PDCD1 across cancers → 26 9 approvedCemiplimab, Dostarlimab, Nivolumab, Pembrolizumab, Retifanlimab, Serplulimab, Sintilimab, Tislelizumab, ToripalimabApproved in Merkel cell carcinoma: Pembrolizumab, Retifanlimab.33 active of 77 Merkel cell carcinoma trials antibody, other clinical modality, protein degrader, small molecule 0 active of 2 trials
PIK3CA across cancers → 31 3 approvedAlpelisib, Copanlisib, InavolisibApproved in breast cancer, breast neoplasm, breast carcinoma and 3 other indications. No Merkel cell carcinoma indication appears on these drugs’ labels.No Merkel cell carcinoma trial of any of these drugs antibody, protein degrader, small molecule
NOTCH1 across cancers → 1 Phase 1BrontictuzumabNo Merkel cell carcinoma trial of any of these drugs antibody, protein degrader, small molecule
KMT2D across cancers → 0 No drug antibody, protein degrader, small molecule
MYCL across cancers → 0 No drug
ATOH1 0 No drug
SOX2 across cancers → 0 No drug protein degrader, small molecule
NCAM1 2 Phase 2Lorvotuzumab Mertansine, Oncolysin S1 trials, none active antibody, other clinical modality, protein degrader, small molecule
LAG3 across cancers → 6 1 approvedRelatlimabApproved in melanoma. No Merkel cell carcinoma indication appears on these drugs’ labels.2 active of 2 Merkel cell carcinoma trials antibody, other clinical modality

Dataset evidence counts studies in the 53-study ranked set whose title or abstract names the gene; the bar is scaled to SOX2. Sources: Open Targets Platform and NCBI GEO, retrieved 2026-09-17. Clinical stage is the highest reached for any indication — see the per-drug indications noted in each row. Target-prioritisation reference only; not clinical or prescribing guidance.

What is actually approved here

openFDA drug labels · weekly

3 drugs carry an FDA label naming Merkel cell carcinoma: Avelumab, Pembrolizumab, Retifanlimab. Separately, 15 of the drugs returned for the genes in the table above are approved only for other diseases and reach Merkel cell carcinoma through trials, not through their labels.

3Labelled for Merkel cell carcinomaFDA INDICATIONS AND USAGE names the disease
15Approved, but for another diseasereturned for the genes in the table above
0Backbone agents listing itbroad cytotoxics whose labels name many tumours
1Active polyomavirus T antigen cell-therapy trialsof 4 registered

Every label that names Merkel cell carcinoma

DrugRoleWhat the label says
AvelumabBAVENCIOLabelled hereMetastatic Merkel Cell Carcinoma BAVENCIO (avelumab) is indicated for the treatment of adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma (MCC) [see Clinical Studies
PembrolizumabKEYTRUDA, KEYTRUDA QLEXLabelled hereMerkel Cell Carcinoma (MCC) for the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma.
RetifanlimabZYNYZLabelled hereMerkel Cell Carcinoma (MCC) for the treatment of adult patients with metastatic or recurrent locally advanced Merkel cell carcinoma (MCC).

4 labels match indications_and_usage:"Merkel cell carcinoma"; they collapse to 3 distinct molecules once salt forms, biosimilars and co-formulated hyaluronidase are merged. Source: openFDA drug label API (api.fda.gov/drug/label.json), retrieved 2026-09-17. Labels change; this reflects the current label text, not the approval history. Not prescribing guidance.

Cell therapy against polyomavirus T antigen

ClinicalTrials.gov · retrieved 2026-09-17 · weekly

polyomavirus T antigen is the busiest cell-therapy antigen in Merkel cell carcinoma: 4 registered trials, 1 still active.

TrialPhaseStatusTitleLast update
NCT055926261/2RecruitingA Study of a Selective T Cell Receptor (TCR) Targeting, Bifunctional Antibody-fusion Molecule STAR0602 in Participants With Advanced Solid Tumors2026-08-11
NCT017584581/2TerminatedViral Oncoprotein Targeted Autologous T Cell Therapy for Merkel Cell Carcinoma2017-04-19
NCT025848291/2TerminatedLocalized Radiation Therapy or Recombinant Interferon Beta and Avelumab With or Without Cellular Adoptive Immunotherapy in Treating Patients With Metastatic Merkel Cell Carcinoma2022-03-22
NCT037474841/2TerminatedGene-Modified Immune Cells (FH-MCVA2TCR) in Treating Patients With Metastatic or Unresectable Merkel Cell Cancer2025-03-06

4 of 4 shown, most recently active first. Other antigens searched: PD-L1 (2), PD-1 (2). Source: ClinicalTrials.gov API v2, retrieved 2026-09-17. Trials are matched on the antigen named in the title or intervention, so a trial stating only a product code is missed.

Research momentum

PubMed MeSH · monthly

Every term below is a share of the Merkel cell carcinoma literature, not a count, because the field itself grew: 2015–2018 (n=507) against 2021–2025 (n=671). A topic whose papers doubled while the field doubled has not risen.

Rising, with a real baseline

MeSH term2015–182021–25ChangeShare now
SEER Program1.38%3.58%2.59×24 papers
CD8-Positive T-Lymphocytes0.99%2.53%2.57×17 papers
Tumor Microenvironment1.58%3.13%1.98×21 papers
Transcription Factors0.99%1.79%1.81×12 papers
Lymphocytes, Tumor-Infiltrating1.18%1.94%1.64×13 papers
Immunotherapy5.13%6.26%1.22×42 papers
Antigens, Viral, Tumor4.34%5.22%1.2×35 papers
Margins of Excision1.78%2.09%1.18×14 papers
Antibodies, Monoclonal, Humanized6.51%7.6%1.17×51 papers
Skin Neoplasms83.04%96.27%1.16×646 papers

Cooling

MeSH term2015–182021–25ChangeShare now
Treatment Outcome14.4%4.62%0.32×31 papers
Antineoplastic Agents5.33%1.79%0.34×12 papers
Diagnosis, Differential5.72%2.09%0.36×14 papers
Disease-Free Survival4.93%1.79%0.36×12 papers
Head and Neck Neoplasms4.73%2.09%0.44×14 papers
Immunohistochemistry12.23%5.51%0.45×37 papers

Biggest topics now

MeSH term2015–182021–25ChangeShare now
Skin Neoplasms83.04%96.27%1.16×646 papers
Merkel cell polyomavirus20.51%22.65%1.1×152 papers
Prognosis15.38%16.1%1.05×108 papers
Polyomavirus Infections12.23%13.71%1.12×92 papers
Neoplasm Staging14.99%12.97%0.86×87 papers
Neoplasm Recurrence, Local9.47%10.58%1.12×71 papers
Tumor Virus Infections11.64%10.28%0.88×69 papers
Biomarkers, Tumor14.0%8.79%0.63×59 papers
Immune Checkpoint Inhibitors0.0%8.49%84948.84×57 papers
Antibodies, Monoclonal, Humanized6.51%7.6%1.17×51 papers

Publication mix

Type2015–182021–25
Randomized Controlled Trial0.0%0.1%
Review14.8%10.9%
Meta-Analysis0.2%0.7%
Case Reports0.0%3.1%

Query: Carcinoma, Merkel Cell[MeSH Major Topic] NOT ("Melanoma"[MeSH] OR "Carcinoma, Squamous Cell"[MeSH] OR "Basal Cell Carcinoma"[MeSH] OR "Small Cell Lung Carcinoma"[MeSH]). Terms need at least 12 papers in the recent window and, in the rising table, at least 5 in the earlier one — a term going from 1 paper to 12 is a large fold change and no evidence of anything. Ubiquitous descriptors (Humans, Animals, age bands) and the disease’s own term are dropped. Source: PubMed MeSH, retrieved 2026-09-17.

Disease burden

What the public sources count, and how closely each category matches this disease. The same figures for every disease on the site are on one table.

MeasureValueMatchWhat it counts
New cases each year3,000 cases/yeardirect
Deaths each yearnot publishedNot published on the page.
Five-year relative survivalnot publishedThe American Cancer Society publishes five-year relative survival by SEER stage, not one figure.
Median age at diagnosisnot publishedNot published as a median: "Most Americans diagnosed with Merkel cell carcinoma are older than age 70."

Years of life lost: not computed. Years of life lost needs survival, age at diagnosis and a case count. five_year_relative_survival, median_age_at_diagnosis is not recorded for this disease.

Funding

NIH RePORTER · quarterly

NIH obligations naming Merkel cell carcinoma, after removing the 213 records across all years that matched the search but are about something else. That filter is not cosmetic: without it this section reports another field’s funding as this disease’s.

$15.9MNIH obligations, FY2025from $7.8M in FY2013 · +104%
21distinct projects funded15 in FY2013
$15.9Mpeak year was FY2025obligations, all institutes
71%of FY2025 awards from NCI20 of 28

NIH obligations by fiscal year

$4M$8M$12M$16M13151719212325
YearObligationsAwardsDistinct projectsDropped as off-topic
FY2013$7.8M151510
FY2014$8.2M161614
FY2015$5.2M171613
FY2016$4.5M121112
FY2017$5.6M131218
FY2018$5.1M10922
FY2019$13.5M211418
FY2020$10.5M201316
FY2021$10.7M201318
FY2022$11.1M201416
FY2023$13.5M251719
FY2024$14.5M252415
FY2025$15.9M282122

Where FY2025 money went

InstitutionObligationsAwards
University Of Washington$5.7M7
University Of Pennsylvania$3.8M4
National Institute Of Arthritis And Musculoskeletal And Skin Diseases$1.7M2
University Of Pittsburgh At Pittsburgh$1.4M2
Dana-Farber Cancer Inst$1.3M2
Stetson University$0.5M1
Southern California Inst For Res/Educ$0.4M1
University Of Michigan At Ann Arbor$0.4M1
University Of Arizona$0.3M1
University Of New Hampshire$0.2M0

Text search Merkel cell carcinoma over project title, terms and abstract, per fiscal year. Awards are individual funding actions; distinct projects collapse them by core project number, so a multi-year grant counts once. The most recent year may be incomplete. Source: NIH RePORTER, retrieved 2026-09-17.

Who funds it, FY2025

The total says how much. These say who from, through what kind of award, and to whom — which a dollar figure cannot.

NIH institutes

NCI20 · 71%
NIAID4 · 14%
NIAMS2 · 7%
VA1 · 4%
NIGMS1 · 4%

Projects by administering institute. The rows above are the top 5 and account for 28 of 28.

Award mechanisms

P0110 · 36%
R018 · 29%
F313 · 11%
ZIA2 · 7%
F301 · 4%
R151 · 4%

R01 is an investigator-initiated grant; ZIA is NIH intramural, meaning the work happens inside NIH rather than being funded outside it. The rows above are the top 9 and account for 28 of 28.

Where it lands

University Of Washington$5.7M · 35.6%
University Of Pennsylvania$3.8M · 23.6%
National Institute Of Arthritis And Musc$1.7M · 11.0%
University Of Pittsburgh At Pittsburgh$1.4M · 8.5%
Dana-Farber Cancer Inst$1.3M · 8.1%
Stetson University$0.5M · 3.5%

Share of $15.9M in FY2025. The top three hold 70%.

Public datasets, ranked

NCBI GEO + Europe PMC + iCite · weekly

103 human GEO series match Merkel cell carcinoma. Keyword relevance cannot tell a 276-sample patient cohort from a six-well cell-line experiment, so this ranking scores four things GEO does not expose: how often the accession is named in full-text papers, field-normalised citation impact, clinical annotation, and cohort type.

Composition of the 53-study ranked set

unspecified 21cell line 14patient 11mixed 7
21 unspecified14 cell line11 patient7 mixed35 carry clinical annotation11 carry survival1 patient cohorts ≥100 GEO samples2,144 GEO samples totalin 5 single-cell series a GEO sample is one cell, not one patient

Established

high reuse, older
AccessionStudySamplesMentionsEurope PMCRCREvidence
GSE117988scRNAseq reveals mechanisms of Merkel cell carcinoma acquired immunotherapy resistance [1]2018 · single-cell6196.5
patient cohortAPT 0.95molecularCTLA4MCPYVPOLYOMAVIRUS248 cites
GSE39612Distinct gene expression profiles of viral- and non-viral associated Merkel cell carcinoma revealed by transcriptome analysis2012 · array138253.1
APT 0.75molecularMCPYVPOLYOMAVIRUSRB1101 cites
GSE22396Gene expression analysis of Merkel Cell Carcinoma2010 · array3596.1
APT 0.75survivalmolecularPOLYOMAVIRUS240 cites
GSE141121PD-1 and TIGIT co-expression identifies a circulating CD8 T cell population predictive of response to anti-PD-1 therapy in melanoma and Merkel-cell carcinoma patients2020 · sequencing27612.1
patient cohortAPT 0.75molecularPD-166 cites
GSE154938Glucose-6-Phosphate Dehydrogenase as a Prognostic Predictor Correlates with the Tumor Immune Activity Including Programmed Death Ligand-1 Expression in Merkel Cell Carcinoma2020 · sequencing4121.7
patient cohortAPT 0.25survivalstagemolecularPD-L125 cites
GSE79968Merkel cell polyomavirus small T antigen promotes pro-glycolytic metabolic perturbations required for transformation2016 · sequencing7832.2
cell lineAPT 0.25molecularMCPYVMYCLPOLYOMAVIRUS68 cites
GSE50451Microarray analysis of Merkel cell carcinoma (MCC) tumors, small cell lung cancer (SCLC) tumors, and MCC cell lines2014 · array77101.7
mixedAPT 0.258 cites
GSE69878MCPyV ST activates Max target genes by recruiting TRRAP/EP400 complex2017 · chromatin3123.6
APT 0.25molecularMCPYV112 cites

Recent

2022 onward, by score
AccessionStudySamplesMentionsEurope PMCRCREvidence
GSE227708Cancer-specific CD8 T cell frequency at baseline in blood correlates with response to PD-1 blockade in Merkel cell carcinoma.2023 · single-cell1642.8
patient cohortAPT 0.75molecularMCPYVPD-1POLYOMAVIRUS25 cites
GSE226438Single cell RNA-seq profiling of patient-derived Merkel cell carcinoma tumor samples2023 · single-cell1161.8
patient cohortAPT 0.25survivalmolecularMCPYVPOLYOMAVIRUS20 cites
GSE235093Pre-existing skin-resident CD8 and γδ T cell circuits mediate immune response in Merkel cell carcinoma and Predict immunotherapy efficacy2024 · sequencing33332.2
APT 0.7522 cites
GSE261681Interlocking core regulatory circuits enable viral hijacking in Merkel cell carcinoma2025 · chromatin4311.4
APT 0.25molecularATOH1MCPYVPOLYOMAVIRUS5 cites
GSE281260Spatially organized inflammatory myeloid-CD8+ T cell aggregates linked to Merkel-cell Polyomavirus driven Reorganization of the Tumor Microenvironment2024 · single-cell1461
patient cohortsurvivalmolecularMCPYVPOLYOMAVIRUS
GSE292992MDM2 degradation overcomes feedback regulation of p53 signaling in Merkel cell carcinoma2026 · sequencing661
mixedAPT 0.05stagemolecularMYCLPOLYOMAVIRUSTP531 cites

Sources: NCBI GEO + Europe PMC + iCite, retrieved 2026-09-17. SubSeries are collapsed to one row per study by linked PMID. Of 103 series retrieved, 0 were dropped by the profile’s exclusion rules and 13 named the disease only in passing. The ranked set is a relevance-ranked sample, not a census, so the composition figures describe the sample only.

Where the gaps are

Derived from the sections above · recomputed on every refresh

Each card below is a disagreement between two of the tables on this page — a drug that exists but was never tried here, a target that looks tested and was not, a gene with no drug whose product has a busy clinical programme. They are computed from the same facts as the tables, so they cannot contradict them.

RB1

No drug, no trial, no clinical programme of any kind. Whatever the biology says, nothing has been built.

PIK3CA

3 approved drugs (Alpelisib, Copanlisib, Inavolisib) and no registered trial in Merkel cell carcinoma. The molecules exist; nobody has tested them here.

KMT2D

No drug, no trial, no clinical programme of any kind. Whatever the biology says, nothing has been built.

MYCL

No drug, no trial, no clinical programme of any kind. Whatever the biology says, nothing has been built.

ATOH1

No drug, no trial, no clinical programme of any kind. Whatever the biology says, nothing has been built.

SOX2

No drug, no trial, no clinical programme of any kind. Whatever the biology says, nothing has been built.

How a machine reads this page

Static

This page is written to be quoted correctly by a model as much as read by a person. The same facts are available as JSON at the sibling URL below, which is what to cite. The cross-disease layer — burden, genes, drugs and antigens across every briefing — is described at /disease/api.json.

Fully server-rendered

Every figure is in the HTML at first byte. No JavaScript runs, no figure is fetched after load, and nothing on this page requires a renderer to see.

Every number carries a source

Each section names the API it came from and the date it was retrieved: Open Targets (2026-09-17), ClinicalTrials.gov (2026-09-17), openFDA (2026-09-17), NCBI GEO (2026-09-17), PubMed (2026-09-17), NIH RePORTER (2026-09-17).

Negatives stated explicitly

Where nothing exists for Merkel cell carcinoma — no drug, no trial, no approval — the page says so in those words rather than omitting the row. An absent row is unquotable; a stated negative is the finding.

Denominators, not just percentages

Every share is printed with the count and the total it came from, so a figure can be checked rather than taken.

The filters are published

5 exclusion patterns are applied to free text before anything is ranked, because MKL-1 (a name that is also a gene) is used as a model system in "MKL1" is the transcription coactivator MRTF-A in most of its papers. What was removed and why is stated in each section rather than silently applied.

{
  "disease": "Merkel cell carcinoma",
  "mesh": "Carcinoma, Merkel Cell",
  "facts": "https://usebiotransfer.org/disease/merkel-cell-carcinoma.json",
  "methods": "https://usebiotransfer.org/methods/",
  "all_diseases": "https://usebiotransfer.org/disease/api.json",
  "note": "Every figure on the page is in that JSON with its source and retrieval date. Quote from it rather than from the HTML."
}