In a nutshell
This review compared the effectiveness of talimogene laherparepvec (Imlygic) with ipilimumab (Yervoy) and vemurafenib (Zelboraf) in the treatment of metastatic (spread to other organs) melanoma. Researchers concluded that talimogene laherparepvec overall survival is at least as good as with ipilimumab and vemurafenib.
Some background
Melanoma can often metastasize quickly. The immunotherapies ipilimumab and vemurafenib are the newer therapies most widely used to treat melanoma. Ipilimumab helps the immune system to kill tumor cells. Vemurafenib is a BRAF inhibitor (used to treat patients with a mutation, or permanent change, in the BRAF gene). The most recently approved therapy for melanoma is talimogene laherparepvec (T-VEC). This drug works with the immune system to combat cancer cells. It is not clear whether these treatments are equally effective at improving overall survival.
Methods & findings
This review indirectly compared the effectiveness of of T-VEC with ipilimumab and vemurafenib in patients with metastatic melanoma. The results of 4 trials were included: 2 trials of ipilimumab, and 1 trial each of vemurafenib and T-VEC.
When factors such as prognosis were accounted for, overall survival (OS, time from treatment until death from any cause) with T-VEC was at least as good as OS with ipilimumab and vemurafenib. T-VEC was particularly effective in patients with melanoma spread to distant areas of the skin and/or the lymph nodes, compared to patients with melanoma spread to other organs.
The bottom line
This review suggested that treatment with T-VEC is at least as effective as with ipilimumab and vemurafenib.
The fine print
This study was an indirect comparison between 4 different studies. To fully understand the differences in effectiveness between these treatments, they must be directly compared in one trial.
This study was funded by Amgen Inc., the producer of T-VEC.
Published By :
Advances in therapy
Date :
Mar 15, 2016
