The Fourth International Merkel Cell Carcinoma Symposium - Project Summary/Abstract This R13 application requests funds to support the Fourth International Merkel Cell Carcinoma Symposium, to be hosted by Dana-Farber Cancer Institute and held in Boston, Massachusetts on April 27-28, 2026. Merkel Cell Carcinoma (MCC) is a highly lethal cancer with a tendency to metastasize early. Since the discovery of the Merkel cell polyomavirus in 2008 by Yuan Chang and Patrick Moore, our understanding of the pathophysiology of MCC has accelerated dramatically. MCC is highly immunogenic and is the most responsive solid cancer to immune checkpoint inhibitor therapy. The goals of this conference are consistent with the mission statements of the NIH, NCI, NCATS, and NIAMS and include: Identify challenges and knowledge gaps in MCC research; Explore opportunities to improve the understanding of MCC biology, pathogenesis, and therapy; Facilitate networking among MCC researchers, clinicians, and patient advocates for the benefit of the patient community; and Promote strategies to improve interest and engagement in the MCC research community and patient care environments. To accomplish these goals, we propose two specific aims: Aim 1. To facilitate and advance meaningful foundational science and clinical research interactions among participants and promote the exchange of best practices in MCC research and care. The international community of MCC researchers and clinicians is vibrant and growing. This in-person Symposium is imperative for advancing existing collaborations, fostering new connections, and promoting the careers of junior scientists and junior clinicians. Special emphasis will be placed on the presentation and discussion of high-impact, unpublished data with the goal of exchanging new research findings, ideas, and developments among basic, translational, and clinical thought leaders who span a broad range of research disciplines focused on MCC and related malignancies. As the Symposium ultimately aims to improve human health and optimize clinical management of MCC, funds are requested to sponsor the participation of two patient advocates including their travel, lodging, and registration. Aim 2. To promote the attendance of trainees, early career scientists, and early career clinicians and to facilitate their interaction with leaders in the international MCC community. This will be accomplished in two ways. First, the cost of registration will be reduced for all trainees and early career scientists and clinicians. Original research abstracts submitted to the conference website will be evaluated for travel awards. All awardees will be paired with invited senior faculty and basic, translational, and clinical leaders in the field to interact with them at roundtable discussions to stimulate discussion and establish mentoring relationships. In addition, the conference will offer Continuing Medical Education credits to encourage clinicians from a wide spectrum of medical specialties and disciplines to attend.