Howard L. Kaufman, MD, chief surgical officer, associate director for Clinical Science, surgical oncologist, Rutgers Cancer Institute of New Jersey, discusses the oncolytic immunotherapy talimogene laherparepvec (T-VEC; Imlygic) for treatment of patients with melanoma, as well as the agent's side effect profile. Kaufman shared this insight during an interview with 

Society for Immunotherapy of Cancer Cancer Immunotherapy 101 meeting

The FDA approved T-VEC in 2015 for patients with melanoma, but the agent is also being explored across other tumor types, Kaufman explains.

T-VEC is associated with some toxicities, including low-grade fever, fatigue, and pain at the injection site, he adds. However, these were easily managed and the agent was found to be very well tolerated overall. 

Videos

Howard L. Kaufman, MD, chief surgical officer, associate director for Clinical Science, surgical oncologist, Rutgers Cancer Institute of New Jersey, discusses oncolytic immunotherapy talimogene laherparepvec (T-VEC; Imlygic) for treatment of patients with melanoma, as well as the agent's side effect profile. 

Dr. Kaufman on T-VEC in Melanoma

Howard L. Kaufman, MD, chief surgical officer, associate director for clinical science, surgical oncologist, Rutgers Cancer Institute of New Jersey, discusses the phase II JAVELIN Merkel 200 study examining avelumab as a treatment for patients with Merkel cell carcinoma.

Patients with advanced disease who were enrolled on the trial had already failed prior treatment with chemotherapy, Kaufman explains. A total of 88 patients were enrolled.

With the intravenous 30-minute treatment of avelumab, Kaufman says the therapy was very well tolerated. Results showed that there was an objective response rate of 31%, with an additional 10% of patients achieving stable disease. Although the median follow-up was 10 months, these early findings—which also show complete responses and disappearance of visceral metastases&mdash;are encouraging, he adds.

Dr. Kaufman on Avelumab in Merkel Cell Carcinoma

Howard L. Kaufman, MD, FACS, Chief Surgical Officer, Associate Director for Clinical Science, Surgical Oncologist, Rutgers Cancer Institute, Society for Immunotherapy of Cancer (SITC) President, discusses the impact of the recent FDA approval of talimogene laherparepvec (T-VEC) for the treatment of melanoma lesions in the skin and lymph nodes.

T-VEC, a genetically modified live oncolytic herpes virus therapy, was approved in melanoma in late October 2015. As a first-in-class agent, T-VEC opens the doors for other oncolytic virus therapies, says Kaufman, who served as an investigator on the pivotal phase III OPTiM study, which led to the drug’s approval. Future research should be focused on better understanding the mechanism of action of T-VEC and how the drug can best be utilized, says Kaufman.

T-VEC should also be investigated in combination with other agents, says Kaufman. Other manipulations of the virus used in T-VEC and other viruses may also have potential.

Dr. Howard L. Kaufman on Impact of T-VEC FDA Approval

In an interview at the Society for Immunotherapy of Cancer (SITC) meeting on Advances in Cancer Immunotherapy held in Princeton, NJ, Howard L. Kaufman, MD, FACS, Chief Surgical Officer, Associate Director for Clinical Science, Rutgers Cancer Institute of New Jersey, discusses the use of oncolytic viruses for the treatment of advanced melanoma.

Kaufman has been investigating talimogene laherparepvec (T-VEC), a herpes simplex virus-1 oncolytic vaccine. This agent has the potential to mediate tumor reduction by directly killing the tumor cells after it is injected and stimulating an immune response, says Kaufman.

A recent large, randomized phase III study demonstrated that T-VEC induced a durable response rate in patients with advanced melanoma, when compared to the control arm. Further studies are underway combining T-VEC with other agents, including checkpoint inhibitors, says Kaufman.

Howard L. Kaufman, MD, FACS, Chief Surgical Officer, Associate Director for Clinical Science, Rutgers Cancer Institute of New Jersey, discusses the use of oncolytic viruses for the treatment of advanced melanoma.

Dr. Kaufman on the Potential of T-VEC for Advanced Melanoma

Howard L. Kaufman, MD, Rush University Medical Center, discusses the implications of the Immunoscore for the treatment of patients with cancer.

The Immunoscore, pioneered by Jérôme Galon, PhD, is based on interesting data from a large number of patients with colorectal cancer. This analysis, Kaufman says, found that the number and location of lymphocytes, particularly T cells, within the tumor microenvironment was highly predictive of prognosis. In fact, Kaufman points out, the Immunoscore was better than the AJCC staging system. While it is well-known that some patients with early stage cancer go on to develop recurrence and some patients with advanced disease might do better, there has been an interesting correlation with the initial look of the T cell response at the tumor site and a patient's prognosis.

The Society for Immunotherapy of Cancer is sponsoring a worldwide effort to analyze the impact of the Immunoscore on prognosis using data collected from multiple institutions in many countries. The Immunoscore has implications beyond colorectal cancer because this T cell response has been seen in other types of cancer including melanoma, breast cancer, and gastric cancer.

If validated, the Immunoscore could provide a better way to understand prognosis for patients with cancer but also select patients who might benefit from immunotherapy in general.

Howard L. Kaufman, MD

Articles

Dr. Kaufman on T-VEC in Melanoma

Dr. Kaufman on Avelumab in Merkel Cell Carcinoma

Dr. Howard L. Kaufman on Impact of T-VEC FDA Approval

Dr. Kaufman on the Potential of T-VEC for Advanced Melanoma

Dr. Kaufman on the Importance of the Immunoscore