Department of Surgical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Int J Cancer. 2019 Aug 15;145(4):974-978. doi: 10.1002/ijc.32172. Epub 2019 Feb 21.
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 (EMA label). The phase 3 OPTiM registration study showed an overall response rate (ORR) of 26%. Since December 2016, 48 eligible patients started treatment at the Netherlands Cancer Institute. We included 26 patients in this study with a follow up time ≥6 months, reporting Overall Response Rate (ORR), Disease Control Rate (DCR), Adverse Events (AE), prior treatment for melanoma and baseline characteristics, documented in a prospectively maintained database. In house developed treatment protocol consists of clinical evaluation, periodic PET-CT and histological biopsies for response evaluation. Median follow-up was 12.5 months. Of 26 patients, 16 (61.5%) had a Complete Response (CR) as their best response. Seven (26.9%) patients had a Partial Response (PR) as their best response, 1 (3.8%) patient Stable Disease (SD) and 2 (7.7%) patients Progressive Disease (PD). Best ORR was 88.5%. DCR was 92.3%. Grade 1-2 AEs occurred in all patients. Mostly, these consisted of fatigue, influenza-like symptoms and injection site erythema. All patients underwent prior treatment. Prior treatment did not influence response or toxicity of T-VEC. Best ORR for T-VEC monotherapy at our institute was 88.5% with 61.5% achieving a CR. This prospective study for T-VEC in early metastatic (stage IIIB/C-IVM1a) melanoma demonstrated superior results to the phase 3 OPTiM study and confirms the role of oncolytic immunotherapy for melanoma.
替莫唑胺(T-VEC)是一种改良的单纯疱疹病毒 1 型(HSV-1),可用于治疗 IIIB/C-IVM1a 期不可切除黑色素瘤患者(EMA 标签)。III 期 OPTiM 注册研究显示总缓解率(ORR)为 26%。自 2016 年 12 月以来,48 名符合条件的患者在荷兰癌症研究所开始接受治疗。我们在这项研究中纳入了 26 名随访时间≥6 个月的患者,报告了总缓解率(ORR)、疾病控制率(DCR)、不良反应(AE)、黑色素瘤的既往治疗和基线特征,这些数据记录在一个前瞻性维护的数据库中。内部开发的治疗方案包括临床评估、定期 PET-CT 和组织学活检以评估反应。中位随访时间为 12.5 个月。在 26 名患者中,16 名(61.5%)的最佳反应为完全缓解(CR)。7 名(26.9%)患者的最佳反应为部分缓解(PR),1 名(3.8%)患者为疾病稳定(SD),2 名(7.7%)患者为疾病进展(PD)。最佳 ORR 为 88.5%。DCR 为 92.3%。所有患者均出现 1-2 级 AE。这些主要包括疲劳、流感样症状和注射部位红斑。所有患者均接受过既往治疗。既往治疗并未影响 T-VEC 的反应或毒性。本研究中心 T-VEC 单药治疗的最佳 ORR 为 88.5%,其中 61.5%的患者达到 CR。这项关于早期转移性(IIIb/C-IVM1a 期)黑色素瘤的 T-VEC 前瞻性研究结果优于 III 期 OPTiM 研究,证实了溶瘤免疫疗法在黑色素瘤中的作用。
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