Budosenid Treatment of Avelumab Induced Autoimmune Colitis in Patient With Metastatic Merkel Cell Carcinoma; A Case Report

Merkel cell carcinoma is a rare and highly agressive primary cutaneous cancer with epithelial and neuroendocrine features. Currently, for stage IV disease, up-front immunotherapy with check-point inhibitors, anti PD-L1 and anti PD-1, is recommanded. We report the case of a patient who was treated with Avelumab for a metastatic Merkel cell carcinoma. He presented a treatment induced grade II immune colitis, treated successfully with oral Budesonid, a synthetic steroid with high topical anti-inflammatory activity, minimal systemic absorption, and fewer side effects.