Cancer Immunology, Immunotherapy

, Volume 66, Issue 5, pp 647–656 | Cite as

Intralesional treatment of metastatic melanoma: a review of therapeutic options

Focussed Research Review


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.


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



Adverse events


Complete responses


Cytotoxic T lymphocyte antigen 4


Dose-limiting toxicity




Eastern Cooperative Oncology Group


European medicine agency


Food and drug administration


Interferon α


Interferon β




Isolated limb perfusion


Immune-related response criteria




Objective response


Objective response rate


Progression-free survival


Partial response


Rose Bengal (Provectus)


Recurrence-free survival


Toll-like receptor 7


Tumor necrosis factor α


Talimogene laherparepvec, Imlygic™ (Amgen)


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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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