Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Unit 463, Houston, TX 77030 USA.
Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd., Houston, TX 77030 USA.
J Immunother Cancer. 2017 Jun 20;5:45. doi: 10.1186/s40425-017-0250-5. eCollection 2017.
Immunotherapy plays a key role in the treatment of metastatic melanoma. Patients with autoimmune conditions and/or on immunosuppressive therapy due to orthotropic transplants, however, are systematically excluded from clinical trials. Talimogene laherparepvec (T-VEC) is the first oncolytic virus to be approved by the FDA for cancer therapy. To our knowledge, this is the first report of T-VEC being administered in the setting of an organ transplant recipient.
Here we present the case of a patient with recurrent locally advanced cutaneous melanoma receiving salvage T-VEC therapy in the setting of orthotropic heart transplantation. After 5 cycles of therapy, no evidence of graft rejection has been observed to date, and the patient achieved a complete remission, and is currently off therapy.
This case advocates for further investigation on the safety and efficacy of immunotherapeutic approaches, such as T-VEC, in solid organ transplant recipients.
免疫疗法在转移性黑色素瘤的治疗中起着关键作用。然而，由于同种异体移植而患有自身免疫性疾病和/或接受免疫抑制治疗的患者，会被系统性地排除在临床试验之外。替莫唑胺（T-VEC）是 FDA 批准的第一种用于癌症治疗的溶瘤病毒。据我们所知，这是首例在器官移植受者中使用 T-VEC 的报告。
在此，我们报告了一例复发性局部晚期皮肤黑色素瘤患者，在同种异体心脏移植的情况下接受挽救性 T-VEC 治疗。到目前为止，经过 5 个周期的治疗，尚未观察到移植物排斥的证据，且患者已达到完全缓解，目前已停止治疗。
该病例主张进一步研究免疫治疗方法（如 T-VEC）在实体器官移植受者中的安全性和有效性。
