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July 2017

Complete Response of Advanced Melanoma Treated With Talimogene Laherparepvec and Subsequent Sweet’s-like Infiltrate

Author Affiliations
  • 1Department of Dermatology, Hospital of the University of Pennsylvania
  • 2Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia
JAMA Dermatol. 2017;153(7):719-721. doi:10.1001/jamadermatol.2017.0466

Talimogene laherparepvec (T-VEC) is an oncolytic immunotherapy that uses a genetically engineered herpes simplex virus type 1 (HSV-1) vector designed to selectively replicate within the tumor cells and produce human granulocyte–macrophage colony–stimulating factor (GM-CSF). When injected into melanoma, it has been shown to induce regression of the injected tumor through a direct lytic effect and of uninjected tumors through the induction of a systemic antitumor immune response, mediated primarily through the virally encoded GM-CSF.1,2 Following approval by the US Food and Drug Administration in October 2015 for use in the treatment of unresectable melanoma,3 T-VEC has been increasingly used. However, the exact mechanism of local and distant antitumor immunity is not completely understood; detailed descriptions of pathologic complete response (pCR) and histopathologic findings of the regressed treated melanoma lesions in the context of T-VEC therapy have been lacking and may offer further insight into the immune mechanism of action. We report the case of a man with advanced melanoma who had a pCR following T-VEC therapy and further discuss the histopathologic findings of the treated lesions.

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