Intralesional Therapy in Metastatic Melanoma

Source: OncLive, February 2019


Axel Hauschild, MD: Let’s make a cut here and use the last minute of this section to discuss intralesional approaches. There is so much clinical trial data out there. It’s confusing for those who are not experts in this field. T-VEC, Merrick, has an established role. It’s approved as single-agent therapy. But we are waiting for data from the MASTERKEY-265 randomized clinical trial that looks at pembrolizumab plus or minus T-VEC.

Caroline Robert, MD, PhD: Maybe you can explain what T-VEC is again?

Merrick I. Ross, MD: Yes. This whole concept of oncolysis is an interesting concept. Whether you use T-VEC, or other viruses, or other agents to stimulate a local response that can initiate a systemic immune response is really an interesting concept. In theory, it makes sense to combine these approaches with anti–PD-1 [anti–programmed cell death protein 1] therapy because they could be synergistic with one another. Maybe you increase or change the tumor microenvironment and increase the expression of PD-L1 [programmed death-ligand 1] and T-cell infiltration into the tumor that could lend itself to a better response rate with a backbone of anti–PD-1.

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