默克尔细胞癌（MCC）是一种罕见的侵袭性皮肤癌，具有很高的转移风险。抗 PD-1/PD-L1 免疫疗法的发展改善了晚期 MCC 的预后，但约 50% 的此类患者未获得持久缓解。本研究通过单中心纵向数据库分析了 183 名晚期 MCC 患者的年龄和体重指数 (BMI) 对免疫治疗反应的影响。使用 Fine-Gray 或 Cox 回归模型评估治疗反应、无进展生存期 (PFS)、MCC 特异性生存期和总生存期 (OS)。年龄与治疗反应呈显着的非线性关系 (p = 0.04)，年龄远大于 70 岁或年龄小于 70 岁的患者出现反应的可能性较小。然而，年龄与 PFS (p = 0.21)、MCC 特异性生存 (p = 0.72) 或 OS (p = 0.36) 没有显着相关性。同样，BMI 与治疗反应 (p = 0.41)、PFS (p = 0.52)、MCC 特异性生存率 (p = 0.78) 或 OS (p = 0.71) 没有显着相关性。之前的研究表明肥胖和高龄可以改善其他癌症的预后，但与此不同的是，在 MCC 中并未观察到这些关联。这些研究结果表明，年龄和体重指数不应影响 MCC 患者接受免疫治疗的资格，强调了这种治疗中公正的患者选择的重要性。

Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a high risk of metastasis. The development of anti-PD-1/PD-L1 immunotherapy has improved outcomes for advanced MCC, yet about 50% of such patients do not achieve durable responses. This study analyzed the effects of age and body mass index (BMI) on immunotherapy response in 183 advanced MCC patients from a single-center longitudinal database. Using Fine-Gray or Cox regression models, treatment response, progression-free survival (PFS), MCC-specific survival, and overall survival (OS) were evaluated. Age showed a significant non-linear relationship with treatment response (p = 0.04), with patients much older or younger than 70 years less likely to respond. However, age was not significantly associated with PFS (p = 0.21), MCC-specific survival (p = 0.72), or OS (p = 0.36). Similarly, BMI was not significantly correlated with treatment response (p = 0.41), PFS (p = 0.52), MCC-specific survival (p = 0.78), or OS (p = 0.71). Unlike previous studies suggesting that obesity and advanced age improve outcomes in other cancers, these associations were not observed in MCC. These findings suggest that age and BMI should not influence eligibility for immunotherapy in MCC patients, emphasizing the importance of unbiased patient selection for this treatment.