Individuals with injectable melanoma fared better when administered talimongene laherparepvec (T-VEC) than those who were given granulocyte macrophage colony-stimulating factor (GM-CSF) in a randomized phase 3 trial.

433 patients whose melanoma was not surgically resectable were randomized to receive either intralesional T-VEC or subcutaneous GM-CSF. Investigators measured durable response rate defined as lasting 6 or more months. They also tracked overall survival and overall response rate.

They found that with T-VEC (compared with GM-CSF):

• Durable response rate was significantly higher: 16.3% vs 2.1%;

• Overall response was higher: 26.4% vs 5.7%

• Median overall survival was higher: 23.3 months vs 18.9 months

Best response was seen in those with stage III, IIIC, IVM1a disease, as well as in those without prior treatment.

The most common side effects in T-VEC patients were fatigue, chills, and pyrexia. About 2% of those taking T-VEC experienced cellulitis. There were no fatal treatment-related adverse events.

The authors noted T-VEC is the first oncolytic immunotherapy to show benefit against melanoma, and represents a novel potential treatment.

Citation: Andtbacka R, Kaufman H, Collichio F, et al. Talimogene Laherparepvec Improves Durable Response Rate in Patients With Advanced Melanoma. J Clin Oncol. 2015;33(5):2780-2788.