I've been enamored of intralesionals/intratumoral therapies for melanoma for years, putting up my most recent post last month which included links to prior posts. Now there is more good news....
High Response Rates for T-VEC in Early Metastatic Melanoma (Stage IIIB/C-IVM1a). Franke, Berger, Klop, et al. Int J Cancer. 2019 Jan 29.
Talimogene laherparepvec (T-VEC) is a
modified herpes simplex virus, type 1 (HSV-1), which can be
administered intralesionally in patients with stage IIIB/C-IVM1a
unresectable melanoma (EMA label). The phase 3 OPTiM registration
study showed an overall response rate (ORR) of 26%. Since December
2016, 48 eligible patients started treatment at the Netherlands
Cancer Institute. We included 26 patients in this study with a follow
up time greater than/ = to 6 months, reporting Overall Response Rate
(ORR), Disease Control Rate (DCR), Adverse Events (AE), prior
treatment for melanoma and baseline characteristics, documented in a
prospectively maintained database. In house developed treatment
protocol consists of clinical evaluation, periodic PET-CT and
histological biopsies for response evaluation. Median follow-up was
12.5 months. Of 26 patients, 16 (61.5%) had a Complete Response (CR)
as their best response. Seven (26.9%) patients had a Partial Response
(PR) as their best response, 1 (3.8%) patient Stable Disease (SD) and
2 (7.7%) patients Progressive Disease (PD). Best ORR was 88.5%. DCR
was 92.3% . Grade 1-2 AE's occurred in all patients. Mostly, these
consisted of fatigue, influenza-like symptoms and injection site
erythema. All patients underwent prior treatment. Prior treatment did
not influence response or toxicity of T-VEC. Best ORR for T-VEC
monotherapy at our institute was 88.5% with 61.5% achieving a CR.
This prospective study for T-VEC in early metastatic (stage
IIIB/C-IVM1a) melanoma demonstrated superior results to the phase 3
OPTiM study and confirms the role of oncolytic immunotherapy for
melanoma.
For a personal real time, real life report there is also this from dear Julie: The development of a red-hot mess after T-VEC necessitating antibiotics and antivirals...but with continued hope for a great response!! Hang tough ratties!! Fingers crossed for a rapid resolution of adverse effects and a complete response for Julie! ~ c
No comments:
Post a Comment