In a nutshell
This review examined the use of intralesional injections to deliver immunotherapy in the treatment of melanoma patients.
Some background
Immunotherapy is a therapeutic approach which stimulates the immune system to respond against cancer cells in the same way the body would normally fight an invading virus or bacteria. For example, in the treatment of melanoma, the immunotherapy agent ipilimumab (Yervoy) has been shown to slow disease progression and improve survival among advanced melanoma patients. Recent research has investigated the possible benefits of intralesional immunotherapy, in which treatment is injected directly into the cancerous lesions. The current review analyzed the use and efficiency of a variety of new developing immunotherapies used in the treatment of advanced melanoma.
Methods & findings
Oncolytic viruses have been the focus of intralesional immunotherapy research in recent years. These genetically altered viruses are not only effective at triggering an immune response against cancer cells, they also directly kill the infected cancer cells by inhibiting important cellular functions.
Talimogene Laherparpvec (T-Vec) is an ocolytic herpes virus that has been genetically engineered to directly target melanoma cells. In an early phase study of 50 patients, intralesional T-Vec therapy showed disease response in 26% of the patients treated. A second study investigating 430 advanced melanoma patients showed a regression of melanoma among 26.4% of patients receiving T-Vec, compared to only 2.1% of patients receiving other forms of immunotherapy. A second oncolytic virus, coxsackie A21, has been found to induce an immune response against melanoma cells, and initial clinical trials are currently ongoing to examine the safety and effectiveness of this treatment.
An intralesional injection combining two immunotherapy drugs, ipilimumab (Yervoy) and nivolumab, was also recently investigated and resulted in melanoma regression in 53% of patients treated.
The bottom line
This review concluded that new intralesional immunotherapies are a promising approach in the treatment of advanced melanoma. Large randomized trials are awaited.
What’s next?
Consult with your physician regarding the risks and benefits of immunotherapies in the treatment of advanced melanoma.
Published By :
Surgical oncology
Date :
Dec 03, 2013
