And this in 2014: "Intralesional melanoma therapy (A procedure in which the "treatment" is directly injected into superficial tumors and in theory, not only does that tumor die, but "by stander" tumors at more distant sites die too!!!) was first recorded back in 1975. A 75 year old male with 64 melanoma mets just below the skin, as well as junk in his lungs, had 17 superficial lesions injected with Bacille Calmette-Guerin over a period of 8 months. (BCG is a vaccine against some strains of tuberculosis, but does contain a weakened version of the bacteria itself within it.) In the end, all 17 tumors injected resolved and his pulmonary mets diminished by more than 50%! However, enthusiasm for BCG as a melanoma treatment waned as patients in subsequent trials experienced anaphylactic reactions and death due to disseminated BCG, and randomized trials failed to replicate significant clinical benefit.
Later, intralesional therapy was tried using all sorts of things. More recently Allovectin-7, OncoVEX, and PV-10 have demonstrated positive results, killing melanoma at the injected site and systemically. [Now we also have CAVATAK, an intralesional derived from the Coxsackievirus: CAVATAK: intralesional therapy derived from the Coxsackievirus]
Allovectin-7, is a soup of DNA, that attempts to change the gene make-up of tumor cells. In a study reported in 2012, it provided a 12% overall response rate with no grade 3 or higher toxicities in patients with stage III/IV melanoma with injectable cutaneous lesions.
OncoVEX is a 2nd generation herpes virus embedded with GM-CSF...a substance that causes the body to make more white cells. (GM-CSF can be given to premature babies and leukemia patients with low white cell counts to help build them back up....and reverse immune suppression.) But, in OncoVEX, it is thought to only replicate in the tumor cells. The white cells produced in the process kill off the tumor cells. In a phase 2 trial reported in 2012, 20% of patients achieved a complete response and 28% gained an overall response. 92% of the responses were durable to at least 6 months, and the majority were ongoing with a range of 18-40 months. Responses were found in patients with all stages and systemic tumors were eradicated in some patients.
Rose Bengal was first utilized in the 1800's to dye fabrics and color the feet of Bengali women red for weddings and celebrations. Later it was used as a staining agent to find corneal lesions and then as an IV preparation to check for impaired liver function. The "Aha!" moment came in the 1980's when Japanese tests of a "food dye" to determine tumor origin, found dose-dependent survival increases. After a few other sundry studies....PV-10 was born. It is a 10% Rose Bengal solution, with a 30-minute half-life, excreted via bile. PV-10 is excluded from normal cells, but slips through the cell membrane of cancer cells (liver, breast, melanoma, and others) because their cell walls have a higher lipid content. Once inside, PV-10 triggers lysosomal release (the part of the cell that digests waste), killing the cell in 30-60 minutes. Antigenic tumor fragments are believed to produce the 'bystander effect' leading to immediate reduction in tumor burden and concomitant immunologic activation."
Here is a link to the entire report and others I've posted here: Info from ASCO 2014 on Rose Bengal (PV-10) and links to more reports
And now....researchers have learned a little more about how it actually works....
Bentie has always believed that dendritic cells are going to hold some important keys to understanding and perhaps treating melanoma! Way to go ratties (and little melanoma-bearing mice)! - c