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.
Parekh V, Gangadhar T, Kreider KL, Elenitsas R, Chu EY. Complete Response of Advanced Melanoma Treated With Talimogene Laherparepvec and Subsequent Sweet’s-like Infiltrate. JAMA Dermatol. 2017;153(7):719–721. doi:10.1001/jamadermatol.2017.0466
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