Fellow, Complex General Surgical Oncology, Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Department of Cutaneous Oncology, Moffitt Cancer Center, Professor of Surgery, University of South Florida Morsani School of Medicine, Tampa, FL, USA.
Expert Opin Biol Ther. 2020 Jan;20(1):9-14. doi: 10.1080/14712598.2020.1689951.
: Intralesional therapies have emerged as effective immune therapies for locally advanced and metastatic melanoma. Talimogene laherparepvec (T-VEC), an oncolytic virus derived from the herpes simplex 1 (HSV-1) virus, is the first and only FDA approved intralesional therapy for recurrent, unresectable cutaneous, subcutaneous or nodal metastases from melanoma.: We discuss results from clinical trials of T-VEC including data on safety, biodistribution, and viral shedding, which established the current treatment protocol and basis for FDA approval. Data are presented from early implementation of T-VEC in clinical practice. We explore the use of T-VEC in the neoadjuvant setting and in combination with anti-CTLA-4 and PD-1 therapies, including available evidence to support a mechanism for the observed synergistic effect.: Intralesional T-VEC is effective for unresectable stage III and IVa melanoma, with early clinical results comparing favorably to response rates from clinical trials. Clinical applications will likely increase as more data become available on its use in the neoadjuvant setting and in combination with other systemic immune therapies. We expect the fields of intralesional therapy and viral oncotherapy to expand as we better understand how to manipulate the tumor microenvironment and host immune response to cancer.
: 局部治疗已成为治疗局部晚期和转移性黑色素瘤的有效免疫疗法。替莫唑胺（T-VEC）是一种源自单纯疱疹病毒 1 型（HSV-1）的溶瘤病毒，是 FDA 批准的第一种也是唯一一种用于治疗复发性、不可切除的皮肤、皮下或淋巴结转移性黑色素瘤的局部治疗方法。: 我们讨论了 T-VEC 的临床试验结果，包括安全性、生物分布和病毒脱落的数据，这些数据确立了目前的治疗方案和 FDA 批准的基础。本文介绍了 T-VEC 在临床实践中的早期应用。我们探讨了 T-VEC 在新辅助治疗中的应用以及与抗 CTLA-4 和 PD-1 治疗联合应用的情况，包括支持观察到协同作用的机制的现有证据。: 局部 T-VEC 对不可切除的 III 期和 IVa 期黑色素瘤有效，早期临床结果与临床试验的缓解率相比具有优势。随着更多关于其在新辅助治疗中的应用以及与其他全身免疫治疗联合应用的数据的出现，临床应用可能会增加。我们预计，随着我们更好地了解如何操纵肿瘤微环境和宿主对癌症的免疫反应，局部治疗和病毒肿瘤治疗领域将不断扩大。
