5666 - Re-introduction of T-VEC Monotherapy in Recurrent Stage IIIB/C-IVM1a melanoma is effective

Background

Talimogene laherparepvec (T-VEC) is a modified herpes simplex virus, type 1 (HSV-1), which can be administered intralesionally in patients with stage IIIB/C-IVM1a unresectable melanoma.

Methods

5 patients with recurrent disease recommenced treatment with T-VEC monotherapy at the Netherlands Cancer Institute after a prior achieved CR. We collected data on response, adverse events (AE) and baseline characteristics. For response evaluation, we used clinical evaluation with photography, 3-monthly PET-CT’s and histological biopsies.

Results

All 5 patients had in-transit metastases on the lower limb. Median age at baseline was 72.1 years with a median follow-up time of 24.5 months. Histologically proven CR (pCR) was achieved after a median of 8 T-VEC courses on the initial exposure. Of 5 patients, 3 (60%) achieved a histologically and/or PET-CT proven CR again after re-introduction of T-VEC with a median of 3 T-VEC courses and 2 (40%) are still currently on treatment. Duration of response (time between first CR and recurrence) varied between 3.8-14.2 months. No patients developed distant metastases. Grade 1 AE’s occurred in all patients. Mostly, these consisted of fatigue, influenza-like symptoms and injection site pain. PET-CT and histological biopsies proved to be a clinically useful tool to evaluate treatment response for T-VEC monotherapy.

Conclusions

Response to re-introduction of T-VEC monotherapy in this select patient population is promising. This real world data on re-introduction of T-VEC monotherapy in stage IIIB/C-IVM1a melanoma suggests T-VEC could be a treatment option for chronic disease control in this group of patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

V. Franke: Advisory / Consultancy, Research grant / Funding (institution): Amgen. M.W.J.M. Wouters: Research grant / Funding (institution): Novartis. W. Van Houdt: Advisory / Consultancy, Research grant / Funding (institution): Amgen. A.C.J. van Akkooi: Advisory / Consultancy, Research grant / Funding (institution): Amgen; Research grant / Funding (institution): novartis; Research grant / Funding (institution): BMS-Merck; Research grant / Funding (institution): Merck-Pfizer. All other authors have declared no conflicts of interest.