Options mapped

Merkel cell carcinoma: options by country

Sourced options by country plus visit-prep questions for Merkel cell carcinoma. Each line links to its regulator, HTA, or guideline source. This page maps options; it does not recommend or rank them.

Options mappedSolid tumorLast checked June 2026

What this page does

Maps options by country

It maps sourced options by country alongside diagnosis wording, stage, test results, specialists, and trial-search terms.

What it does not do

Does not choose treatment

It does not rank treatments, recommend a choice, or decide clinical fit.

Where it comes from

Built on trusted sources

Every option links to a trusted regulator, HTA, or guideline source, and the list grows as new sources pass verification.

Information to gather before the next visit

Is the MCC localized, stage III, recurrent locally advanced, or metastatic?
Is systemic treatment being considered as first-line, after prior therapy, or in a clinical-trial setting?
Which checkpoint inhibitor is approved or accessible through the treating center and payer?
Is the MCC metastatic and is the patient an adult under the EMA indication?

Trial-search terms to discuss

Merkel cell carcinoma clinical trial

Options by country

Treatments by country

Regulatory and access status by country, from official sources. It shows what exists and where — not a recommendation.

European Union

Avelumab (Bavencio)[1]EMA authorisedNo biomarker requirement stated in fetched EMA Bavencio page; Adult metastatic Merkel cell carcinoma. · EMA central authorization does not establish reimbursement or availability in Germany, France, or other EU member states. No claim is made for localized MCC or pediatric use in the EU from this fetched source. Confidence/conflicts: High for EMA authorization text; member-state access remains a gap.
Avelumab (Bavencio)[1]EMA authorisedNo biomarker requirement stated in fetched EMA Bavencio page; Adult metastatic Merkel cell carcinoma. · EMA central authorization does not establish reimbursement or availability in Germany, France, or other EU member states. No claim is made for localized MCC or pediatric use in the EU from this fetched source. Confidence/conflicts: High for EMA authorization text; member-state access remains a gap.

United Kingdom

Avelumab (Bavencio)[2]ApprovedNo biomarker requirement stated in fetched NICE recommendation; Adults with untreated metastatic MCC who have not had chemotherapy for metastatic disease; post-chemotherapy routine NHS availability noted by NICE. · NICE recommendation is an England/Wales NHS appraisal context and includes a commercial arrangement. It does not establish MHRA label wording, Scotland/Northern Ireland status, or individual suitability. Confidence/conflicts: High for NICE recommendation text; devolved UK and MHRA label specifics remain active gaps.
Avelumab (Bavencio)[2]ApprovedNo biomarker requirement stated in fetched NICE recommendation; Adults with untreated metastatic MCC who have not had chemotherapy for metastatic disease; post-chemotherapy routine NHS availability noted by NICE. · NICE recommendation is an England/Wales NHS appraisal context and includes a commercial arrangement. It does not establish MHRA label wording, Scotland/Northern Ireland status, or individual suitability. Confidence/conflicts: High for NICE recommendation text; devolved UK and MHRA label specifics remain active gaps.

Sources

European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
NICE — technology appraisal recommendation · technology appraisal recommendation

This is official regulatory and access status only — not medical advice, not a recommendation, and not a statement about eligibility. Whether any option fits depends on your situation and your oncology team. Status changes over time; confirm the current position with the linked source. Last checked 2026-06-12.

Beyond approved care

In clinical trials & emerging options

Options that are not — or not yet — an approved standard where you live: studies, clinical trials, off-label use, and early evidence that your own oncologist may not raise. Each is labeled by how strong the evidence is. A listing here is information to research and discuss with your team; it does not mean a treatment is proven, safe for you, or available today.

In clinical trials

Immune checkpoint inhibitors including avelumab (Bavencio), pembrolizumab (Keytruda), retifanlimab-dlwr (Zynyz); surgery; radiation therapy; chemotherapy; palliative surgery/radiationClinical trialClinical trialInvestigationalUnited States · Merkel cell polyomavirus (MCPyV) and PD-L1 status discussed by NCI as biologic/evidence context; no biomarker required in fetched FDA approval notices; Advanced MCC first-line systemic context; recurrent locally advanced or metastatic MCC; metastatic MCC; neoadjuvant/adjuvant immunotherapy under clinical evaluation. · NCI PDQ is an evidence summary, not a payer source. FDA accelerated approvals may depend on ongoing confirmatory evidence. This finding does not establish individual eligibility, toxicity suitability, or sequencing among checkpoint inhibitors. Confidence/conflicts: High for U.S. evidence-summary and approvals; accelerated-approval and payer details remain caveats. DailyMed / U.S. FDA label — official drug label
Immune checkpoint inhibitors including avelumab (Bavencio), pembrolizumab (Keytruda), retifanlimab-dlwr (Zynyz); surgery; radiation therapy; chemotherapy; palliative surgery/radiationClinical trialClinical trialInvestigationalUnited States · Merkel cell polyomavirus (MCPyV) and PD-L1 status discussed by NCI as biologic/evidence context; no biomarker required in fetched FDA approval notices; Advanced MCC first-line systemic context; recurrent locally advanced or metastatic MCC; metastatic MCC; neoadjuvant/adjuvant immunotherapy under clinical evaluation. · NCI PDQ is an evidence summary, not a payer source. FDA accelerated approvals may depend on ongoing confirmatory evidence. This finding does not establish individual eligibility, toxicity suitability, or sequencing among checkpoint inhibitors. Confidence/conflicts: High for U.S. evidence-summary and approvals; accelerated-approval and payer details remain caveats. DailyMed / U.S. FDA label — official drug label
Immune checkpoint inhibitors including avelumab (Bavencio), pembrolizumab (Keytruda), retifanlimab-dlwr (Zynyz); surgery; radiation therapy; chemotherapy; palliative surgery/radiationClinical trialClinical trialInvestigationalUnited States · Merkel cell polyomavirus (MCPyV) and PD-L1 status discussed by NCI as biologic/evidence context; no biomarker required in fetched FDA approval notices; Advanced MCC first-line systemic context; recurrent locally advanced or metastatic MCC; metastatic MCC; neoadjuvant/adjuvant immunotherapy under clinical evaluation. · NCI PDQ is an evidence summary, not a payer source. FDA accelerated approvals may depend on ongoing confirmatory evidence. This finding does not establish individual eligibility, toxicity suitability, or sequencing among checkpoint inhibitors. Confidence/conflicts: High for U.S. evidence-summary and approvals; accelerated-approval and payer details remain caveats. DailyMed / U.S. FDA label — official drug label
Immune checkpoint inhibitors including avelumab (Bavencio), pembrolizumab (Keytruda), retifanlimab-dlwr (Zynyz); surgery; radiation therapy; chemotherapy; palliative surgery/radiationClinical trialClinical trialInvestigationalUnited States · Merkel cell polyomavirus (MCPyV) and PD-L1 status discussed by NCI as biologic/evidence context; no biomarker required in fetched FDA approval notices; Advanced MCC first-line systemic context; recurrent locally advanced or metastatic MCC; metastatic MCC; neoadjuvant/adjuvant immunotherapy under clinical evaluation. · NCI PDQ is an evidence summary, not a payer source. FDA accelerated approvals may depend on ongoing confirmatory evidence. This finding does not establish individual eligibility, toxicity suitability, or sequencing among checkpoint inhibitors. Confidence/conflicts: High for U.S. evidence-summary and approvals; accelerated-approval and payer details remain caveats. DailyMed / U.S. FDA label — official drug label
Immune checkpoint inhibitors including avelumab (Bavencio), pembrolizumab (Keytruda), retifanlimab-dlwr (Zynyz); surgery; radiation therapy; chemotherapy; palliative surgery/radiationClinical trialClinical trialInvestigationalUnited States · Merkel cell polyomavirus (MCPyV) and PD-L1 status discussed by NCI as biologic/evidence context; no biomarker required in fetched FDA approval notices; Advanced MCC first-line systemic context; recurrent locally advanced or metastatic MCC; metastatic MCC; neoadjuvant/adjuvant immunotherapy under clinical evaluation. · NCI PDQ is an evidence summary, not a payer source. FDA accelerated approvals may depend on ongoing confirmatory evidence. This finding does not establish individual eligibility, toxicity suitability, or sequencing among checkpoint inhibitors. Confidence/conflicts: High for U.S. evidence-summary and approvals; accelerated-approval and payer details remain caveats. DailyMed / U.S. FDA label — official drug label
Immune checkpoint inhibitors including avelumab (Bavencio), pembrolizumab (Keytruda), retifanlimab-dlwr (Zynyz); surgery; radiation therapy; chemotherapy; palliative surgery/radiationClinical trialClinical trialInvestigationalUnited States · Merkel cell polyomavirus (MCPyV) and PD-L1 status discussed by NCI as biologic/evidence context; no biomarker required in fetched FDA approval notices; Advanced MCC first-line systemic context; recurrent locally advanced or metastatic MCC; metastatic MCC; neoadjuvant/adjuvant immunotherapy under clinical evaluation. · NCI PDQ is an evidence summary, not a payer source. FDA accelerated approvals may depend on ongoing confirmatory evidence. This finding does not establish individual eligibility, toxicity suitability, or sequencing among checkpoint inhibitors. Confidence/conflicts: High for U.S. evidence-summary and approvals; accelerated-approval and payer details remain caveats. DailyMed / U.S. FDA label — official drug label
Pembrolizumab; avelumab; AZD6750; rilvegostomig; INCB099280Clinical trial · NCT07302347Clinical trialTrial only (registry)Japan · MSI-H/dMMR and PD-L1 amplification apply to selected broad solid-tumor cohorts; no MCC biomarker requirement stated for Japan pembrolizumab or avelumab records; Japanese adult MCC; metastatic MCC in JAVELIN Merkel 200; advanced/metastatic solid tumors including MCC. · Registry records do not establish PMDA approval, reimbursement, routine access, or individual eligibility. Broad solid-tumor studies do not prove MCC-specific enrollment at every Japan site. Some studies are completed or active only in specific cohorts. Confidence/conflicts: High for Japan registry-listed MCC-related studies; local approval/access unverified. ClinicalTrials.gov — clinical-trial registry
Pembrolizumab; avelumab; AZD6750; rilvegostomig; INCB099280Clinical trial · NCT07302347Clinical trialTrial only (registry)Japan · MSI-H/dMMR and PD-L1 amplification apply to selected broad solid-tumor cohorts; no MCC biomarker requirement stated for Japan pembrolizumab or avelumab records; Japanese adult MCC; metastatic MCC in JAVELIN Merkel 200; advanced/metastatic solid tumors including MCC. · Registry records do not establish PMDA approval, reimbursement, routine access, or individual eligibility. Broad solid-tumor studies do not prove MCC-specific enrollment at every Japan site. Some studies are completed or active only in specific cohorts. Confidence/conflicts: High for Japan registry-listed MCC-related studies; local approval/access unverified. ClinicalTrials.gov — clinical-trial registry
Pembrolizumab; avelumab; AZD6750; rilvegostomig; INCB099280Clinical trial · NCT07302347Clinical trialTrial only (registry)Japan · MSI-H/dMMR and PD-L1 amplification apply to selected broad solid-tumor cohorts; no MCC biomarker requirement stated for Japan pembrolizumab or avelumab records; Japanese adult MCC; metastatic MCC in JAVELIN Merkel 200; advanced/metastatic solid tumors including MCC. · Registry records do not establish PMDA approval, reimbursement, routine access, or individual eligibility. Broad solid-tumor studies do not prove MCC-specific enrollment at every Japan site. Some studies are completed or active only in specific cohorts. Confidence/conflicts: High for Japan registry-listed MCC-related studies; local approval/access unverified. ClinicalTrials.gov — clinical-trial registry
Navtemadlin (KRT-232) with or without anti-PD-1/anti-PD-L1 therapy including avelumab; AZD6750 plus rilvegostomig; MDNA11 plus pembrolizumabClinical trial · NCT03787602Clinical trialTrial only (registry)Korea · MSI-H, dMMR, or high tumor mutational burden may apply to some broad IL-2 study cohorts; no MCC-specific biomarker requirement stated in KRT-232/avelumab record; MCC; advanced or metastatic solid tumors including MCC; advanced/unresectable solid tumor cohorts including MCC. · Registry records do not establish MFDS approval, reimbursement, routine access, or individual eligibility. Some study statuses are unknown or active-not-recruiting at South Korea sites. Confidence/conflicts: High for Korea registry-listed MCC activity; regulator/access status unverified. ClinicalTrials.gov — clinical-trial registry
Navtemadlin (KRT-232) with or without anti-PD-1/anti-PD-L1 therapy including avelumab; AZD6750 plus rilvegostomig; MDNA11 plus pembrolizumabClinical trial · NCT03787602Clinical trialTrial only (registry)Korea · MSI-H, dMMR, or high tumor mutational burden may apply to some broad IL-2 study cohorts; no MCC-specific biomarker requirement stated in KRT-232/avelumab record; MCC; advanced or metastatic solid tumors including MCC; advanced/unresectable solid tumor cohorts including MCC. · Registry records do not establish MFDS approval, reimbursement, routine access, or individual eligibility. Some study statuses are unknown or active-not-recruiting at South Korea sites. Confidence/conflicts: High for Korea registry-listed MCC activity; regulator/access status unverified. ClinicalTrials.gov — clinical-trial registry
Navtemadlin (KRT-232) with or without anti-PD-1/anti-PD-L1 therapy including avelumab; AZD6750 plus rilvegostomig; MDNA11 plus pembrolizumabClinical trial · NCT03787602Clinical trialTrial only (registry)Korea · MSI-H, dMMR, or high tumor mutational burden may apply to some broad IL-2 study cohorts; no MCC-specific biomarker requirement stated in KRT-232/avelumab record; MCC; advanced or metastatic solid tumors including MCC; advanced/unresectable solid tumor cohorts including MCC. · Registry records do not establish MFDS approval, reimbursement, routine access, or individual eligibility. Some study statuses are unknown or active-not-recruiting at South Korea sites. Confidence/conflicts: High for Korea registry-listed MCC activity; regulator/access status unverified. ClinicalTrials.gov — clinical-trial registry
Cosibelimab (CK-301)Clinical trial · NCT03212404Clinical trialTrial only (registry)Thailand · No biomarker requirement stated in fetched cosibelimab record for MCC cohort; Advanced cancers including Merkel cell carcinoma. · This is a broad advanced-cancer phase 1 record and does not establish MCC-specific enrollment at each Thailand or Russia site. It does not establish Thai FDA or Russian regulator approval, reimbursement, routine access, or current enrollment. Confidence/conflicts: Medium-high for Thailand/Russia broad advanced-cancer registry activity including MCC; MCC-specific site enrollment and local access unverified. ClinicalTrials.gov — clinical-trial registry
Cosibelimab (CK-301)Clinical trial · NCT03212404Clinical trialTrial only (registry)Thailand · No biomarker requirement stated in fetched cosibelimab record for MCC cohort; Advanced cancers including Merkel cell carcinoma. · This is a broad advanced-cancer phase 1 record and does not establish MCC-specific enrollment at each Thailand or Russia site. It does not establish Thai FDA or Russian regulator approval, reimbursement, routine access, or current enrollment. Confidence/conflicts: Medium-high for Thailand/Russia broad advanced-cancer registry activity including MCC; MCC-specific site enrollment and local access unverified. ClinicalTrials.gov — clinical-trial registry

A clinical-trial listing or early report shows an option is being studied — not that it works, that it is safe for any one person, or that a site is enrolling today. Whether any of these fits is a conversation for your oncology team and the trial team. Last checked 2026-06-12.