Department of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek (NKI-AVL), Amsterdam, The Netherlands.
Department of Surgical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.
Crit Rev Oncol Hematol. 2022 Jul;175:103705. doi: 10.1016/j.critrevonc.2022.103705. Epub 2022 May 13.
Single-agent Talimogene Laherparepvec (T-VEC) was developed for treatment of unresectable and injectable stage III-IV melanoma. Since its approval and reimbursement, studies have reported varying response rates. The purpose of this systematic review and meta-analysis was to investigate the efficacy and safety of T-VEC. Of 341 publications that were identified, eight studies with a total of 642 patients were included. In patients with stage IIIB-IVM1a, the pooled complete- and overall response rate (CRR and ORR) were 41% and 64%, respectively. In patients with stage IIIB-IVM1c, the pooled CRR and ORR were 30% and 44%, respectively. In patients with stage IVM1b and IVM1c, the pooled CRR and ORR were 4% and 9%, respectively. Adverse events (AEs) were seen in 41-100% of all patients and 0-11% of AEs were severe. In conclusion, single agent T-VEC achieves the highest response rates in patients with early metastatic melanoma and is well-tolerated with generally only mild toxicities.
单药替莫唑胺（T-VEC）是为治疗不可切除和可注射的 III-IV 期黑色素瘤而开发的。自获得批准和报销以来，已有研究报告了不同的反应率。本系统评价和荟萃分析的目的是研究 T-VEC 的疗效和安全性。在确定的 341 篇出版物中，有 8 项研究共纳入 642 名患者。在 IIIB-IVM1a 期患者中，完全缓解率和总缓解率（CRR 和 ORR）的合并值分别为 41%和 64%。在 IIIB-IVM1c 期患者中，CRR 和 ORR 的合并值分别为 30%和 44%。在 IVM1b 和 IVM1c 期患者中，CRR 和 ORR 的合并值分别为 4%和 9%。所有患者的不良反应（AE）发生率为 41%-100%，AE 发生率为 0-11%，且为严重程度较低的不良反应。总之，单药 T-VEC 在早期转移性黑色素瘤患者中可达到最高的缓解率，且耐受性良好，一般仅出现轻微毒性。
