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DKTK Essen/Düsseldorf: New findings support immunotherapy of skin cancer

No. 30 | 31/05/2017 | by AM

Merkel cell carcinoma of the skin is often invisible for the body’s immune defense because it silences specific genes of the immune system. Scientists from the German Cancer Consortium (DKTK) at the Medical Faculty of Duisburg Essen University at Essen University Hospital have found a way how to make the tumor a target for the immune system again. Thus, immunotherapeutic approaches in the treatment of skin cancer might become much more effective. In the German Cancer Consortium (DKTK), the German Cancer Research Center (DKFZ) in Heidelberg joins up as a core center in long-term collaborations with partner university institutes and hospitals all over Germany that are specialized in research and treatment with a focus on oncology.

© Prof. Lorenzo Cerroni /Medizinischen Universität Graz

Immunotherapy is today one of the most promising treatment methods for a number of skin cancers. Various immunotherapeutic approaches are also being used to treat Merkel cell carcinoma, a rare type of skin cancer that is particularly aggressive. However, only about 50 percent of the patients currently benefit from immunotherapy.

The cause for this is to be found in the molecular makeup of the immune system and in the way cancer cells manipulate it. In prior studies, scientists already noticed that in some patients Merkel cell tumors are overseen by the immune defense because they do no present human leukocyte antigens (HLA) on their cell surface. The HLA system plays a key role in humans for the process of labeling cancer cells for destruction by immune cells. 

In the present study, scientists from the German Caner Consortium (DKTK) at Essen University Hospital have been the first to discover the mechanisms that the cancer cells use for their camouflage. The tumor uses so-called epigenetic mechanisms in order to silence genes that are essential for antigen presentation.

“The majority of Merkel cell carcinomas in Europe are caused by infection with the Merkel cell polyoma virus, which strongly manipulates the epigenetics of tumor cells,” said Professor Jürgen Becker, who is last author of the study and head of the DKTK working group “Translational Skin Cancer Research” at Essen University Hospital. “An important chemical label, the histone acetylation, is removed in the reprogrammed cancer cells. This leads to the silencing of various immune genes – a phenomenon that is also known as ‘epigenetic silencing’”. Genes that are involved in the presentation of tumor antigens on the surface of cancer cells are thus being silenced, and the immune system no longer recognizes the tumor cells.

In collaboration with colleagues from the University of Washington and Massachusetts General Hospital in Boston, the scientists have now found two methods to reverse this mechanism. One is to equip the cancer cells with the missing processed antigens. The cancer cells subsequently present them on their surface and are attacked and destroyed by T cells. In further experiments, the researchers blocked the key enzyme that is responsible for the inactivation, histone deacetylase (HDAC). As a result, the genes that are responsible for antigen presentation were reactivated and the tumor cell surfaces were loaded with more HLA again.

“Our results show that the camouflage in Merkel cell carcinoma can be reversed pharmacologically,” said Becker, a physician. He is confident that the new findings will improve clinical outcomes of immunotherapies to treat this type of skin cancer. “First we will test the effectiveness of various combination therapies with clinically applicable HDAC inhibitors. The next goal is to conduct clinical trials with patients for whom immunotherapeutic approaches have been ineffective until now.”

Cathrin Ritter et al.: Epigenetic priming restores the HLA class-I antigen processing machinery expression in Merkel cell carcinoma. In: Scientific Reports 2017,


* The German Cancer Consortium (DKTK) is a joint long-term initiative involving the German Federal Ministry of Education and Research (BMBF), participating German states and the German Cancer Research Center (DKFZ) and was established as one of six German Health Research Centres (DZGs). As DKTK's core center the DKFZ works together with research institutions and hospitals in Berlin, Dresden, Essen/Düsseldorf, Frankfurt/Mainz, Freiburg, Munich, Heidelberg and Tübingen to create the best possible conditions for clinically oriented cancer research. The consortium promotes interdisciplinary research at the interface between basic research and clinical research, as well as clinical trials for innovative treatments and diagnostic methods. Another key focus of the consortium's work is on developing research platforms to speed up the application of personalized cancer treatments and to improve the diagnosis and prevention of cancer.

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The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) with its more than 3,000 employees is the largest biomedical research institute in Germany. At DKFZ, more than 1,000 scientists investigate how cancer develops, identify cancer risk factors and endeavor to find new strategies to prevent people from getting cancer. They develop novel approaches to make tumor diagnosis more precise and treatment of cancer patients more successful. The staff of the Cancer Information Service (KID) offers information about the widespread disease of cancer for patients, their families, and the general public. Jointly with Heidelberg University Hospital, DKFZ has established the National Center for Tumor Diseases (NCT) Heidelberg, where promising approaches from cancer research are translated into the clinic. In the German Consortium for Translational Cancer Research (DKTK), one of six German Centers for Health Research, DKFZ maintains translational centers at seven university partnering sites. Combining excellent university hospitals with high-profile research at a Helmholtz Center is an important contribution to improving the chances of cancer patients. DKFZ is a member of the Helmholtz Association of National Research Centers, with ninety percent of its funding coming from the German Federal Ministry of Education and Research and the remaining ten percent from the State of Baden-Württemberg.


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