Intralesional treatment of metastatic melanoma: a review of therapeutic options

Focussed Research Review

DOI: 10.1007/s00262-016-1952-0

Cite this article as:
Weide, B., Neri, D. & Elia, G. Cancer Immunol Immunother (2017). doi:10.1007/s00262-016-1952-0

Abstract

Intralesional therapy of melanoma patients with locally advanced metastatic disease is attracting increasing interest, not least due to its ability to lead to both direct tumor cell killing and the stimulation of both a local and a systemic immune response. An obvious pre-requisite for this type of approach is the presence of accessible metastases that are amenable to direct injection with the therapeutic agent of interest. Patients who present with these characteristics belong to stages IIIB/C or IV of the disease. Surgical resection with intention to cure is the standard of care for patients with limited tumor burden and confined spread of disease (resectable patients). However, this category of patients is at a high risk of further recurrences until the disease becomes inoperable (unresectable) or progresses to a more advanced stage with visceral organ involvement, after which the prognosis is particularly grim. Most of the intralesional treatments tested so far, including the recently approved oncolytic virus talimogene laherparepvec, target the subpopulation of patients with unresectable disease, but the possibility to use the intralesional treatment in a neoadjuvant setting for fully resectable patients is attracting considerable interest. The present article reviews approved products and advanced stage pharmaceutical agents in development for the intralesional treatment of melanoma patients.

Keywords

Intralesional Immunocytokine Neoadjuvant Stage III B/C melanoma Phase 3 CIMT 2016 

Abbreviations

AEs

Adverse events

CR

Complete responses

CTLA-4

Cytotoxic T lymphocyte antigen 4

DLT

Dose-limiting toxicity

DPCP

Diphencyprone

ECOG

Eastern Cooperative Oncology Group

EMA

European medicine agency

FDA

Food and drug administration

IFNa

Interferon α

IFNb

Interferon β

IL2

Interleukin-2

ILP

Isolated limb perfusion

irRC

Immune-related response criteria

ITT

Intention-to-treat

OR

Objective response

ORR

Objective response rate

PFS

Progression-free survival

PR

Partial response

PV-10

Rose Bengal (Provectus)

RFS

Recurrence-free survival

TLR7

Toll-like receptor 7

TNF

Tumor necrosis factor α

T-Vec

Talimogene laherparepvec, Imlygic™ (Amgen)

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of DermatologyUniversity Medical Center TübingenTübingenGermany
  2. 2.Department of Chemistry and Applied BiosciencesSwiss Federal Institute of Technology ZurichZurichSwitzerland
  3. 3.Philochem AGOtelfingenSwitzerland

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