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Talimogene Laherparepvec (TVEC) for the Treatment of Advanced Melanoma: A Single-Institution Experience

  • Melanoma
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Abstract

Background

Talimogene laherparepvec (TVEC) is an oncolytic herpes virus used as intralesional therapy for patients with unresectable stage IIIB through IV melanoma. We reviewed the standard of care treatment of TVEC at a single institution.

Methods

All patients treated with TVEC for advanced melanoma were retrospectively evaluated from 2015 to 2018. Patient demographics, clinicopathologic characteristics, treatment response, and toxicity were reviewed.

Results

Twenty-seven patients underwent therapy with TVEC. Median age was 75 years, and 63% of patients were female. Seventeen (63.0%) patients underwent injections on the lower extremity, four (14.8%) on the upper extremity, four (14.8%) on the head and neck, and two (7.4%) on the trunk. Median number of injections was five. Median follow-up was 8.6 months. Of the 27 patients, 23 patients met the criteria for response analysis with at least 8 weeks follow-up. Ten (43.5%) patients experienced a complete response (CR), three (13.1%) experienced a partial response (PR), and five (21.7%) had stable disease (SD) for an overall response rate of 56.5% (CR + PR) and a disease control rate of 78.3% (CR + PR + SD). Adverse events were mostly limited to mild constitutional symptoms within 48 h of injection. Two patients developed cellulitis treated with oral antibiotics, and one patient underwent excision of a lesion for ulceration and bleeding during therapy.

Discussion

TVEC is an effective and well-tolerated intralesional therapy for patients with unresectable stage IIIB through IV melanoma. A CR was achieved in almost half of patients treated. Disease control is seen in the vast majority.

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Fig. 1
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(Top row images previously published in: Miura JT, Zager JS. Intralesional therapy as a treatment for locoregionally metastatic melanoma. Expert Rev Anticancer Ther. 2018;18(4):399–408)

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Author information

Authors and Affiliations

  1. Department of Cutaneous Oncology, Moffitt Cancer Center, 10920 North McKinley Drive, Tampa, FL, 33612, USA

    Matthew C. Perez MD, John T. Miura MD, Amanda Holstein BS, Daniel Lee BS, Amod A. Sarnaik MD & Jonathan S. Zager MD, FACS

  2. Department of Biostatistics, Moffitt Cancer Center, Tampa, FL, USA

    Syeda Mahrukh Hussnain Naqvi MD, MPH & Youngchul Kim PhD

Authors
  1. Matthew C. Perez MD
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  2. John T. Miura MD
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  3. Syeda Mahrukh Hussnain Naqvi MD, MPH
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  4. Youngchul Kim PhD
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  5. Amanda Holstein BS
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  6. Daniel Lee BS
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  7. Amod A. Sarnaik MD
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  8. Jonathan S. Zager MD, FACS
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Corresponding author

Correspondence to Jonathan S. Zager MD, FACS.

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Disclosures

JSZ, consultant, Amgen; speaker bureau, Amgen; research funding, Amgen; AAS, research funding, Amgen; MCP, research funding, Amgen.

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Perez, M.C., Miura, J.T., Naqvi, S.M.H. et al. Talimogene Laherparepvec (TVEC) for the Treatment of Advanced Melanoma: A Single-Institution Experience. Ann Surg Oncol 25, 3960–3965 (2018). https://doi.org/10.1245/s10434-018-6803-0

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  • DOI: https://doi.org/10.1245/s10434-018-6803-0

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