Robert Andtbacka, MD, associate professor in the Division of Surgical Oncology, Department of Surgery at the University of Utah School of Medicine, discusses the future of talimogene laherparapvec (T-VEC; Imlygic) in the treatment of patients with melanoma.

T-VEC was approved in 2015 for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery, based on results from the phase III OPTiM study. In the study, T-VEC showed durable response rates and high overall response rates in patients with unresectable stage IIIb, IIIc, and IVM1a melanoma.

According to findings from the OPTiM study, patients who have stage III melanoma who have received T-VEC have a lower risk of developing lung, liver, and bone metastases. This is encouraging for patients with earlier disease, Andtbacka says, as T-VEC may be able prevent or delay advanced disease. This is being expanded to patients with resectable disease.

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Robert Andtbacka, MD, associate professor in the Division of Surgical Oncology, Department of Surgery at the University of Utah School of Medicine, discusses the future of talimogene laherparapvec (T-VEC; Imlygic) in the treatment of patients with melanoma.
 

Dr. Andtbacka Discusses Next Steps With T-VEC in Melanoma

Robert Andtbacka, MD, associate professor in the Division of Surgical Oncology, Department of Surgery at the University of Utah School of Medicine, discusses combination therapy in melanoma.

For patients with advanced disease, such as those who develop lung and liver metastases, combination therapy has shown to provide more benefit than monotherapy, says Andtbacka. In a study of the combination of ipilimumab (Yervoy) and talimogene laherparepvec (T-VEC; Imlygic) versus ipilimumab alone, there was almost a doubling in response rates for patients who were given the combination, according to Andtbacka. Additionally, there does not seem to be any added adverse events than what is typically seen with ipilimumab.

The combination of pembrolizumab (Keytruda) and T-VEC elicited high response rates in patients with advanced melanoma in a small study. These data have set the stage for a larger study involving this combination, Andtbacka says.

Dr. Andtbacka Discusses Combination Therapy in Melanoma

Robert Andtbacka, MD, associate professor in the Division of Surgical Oncology, Department of Surgery at the University of Utah School of Medicine, discusses the role of talimogene laherparapvec (T-VEC; Imlygic) in the treatment of patients with melanoma.

T-VEC is a herpes simplex virus that has been simplified, and has been used quite extensively in patients with metastatic melanoma, says Andtbacka. The OPTiM study led to the 2015 FDA approval of T-VEC for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery. In this study, T-VEC showed durable response rates and high overall response rates in patients with unresectable stage IIIb, IIIc, and IVM1a melanoma. Andtbacka says that T-VEC is particularly beneficial for patients with regional metastases who do not yet have distant metastases.

Additionally, T-VEC has the ability to reduce the risk of distant disease for many of these patients. In an ongoing neoadjuvant study of patients with melanoma with resectable disease, T-VEC is being administered for 12 weeks before surgery. This will be compared with upfront surgery, and data are expected in late 2018.

Robert Andtbacka, MD, associate professor in the Division of Surgical Oncology, Department of Surgery at the University of Utah School of Medicine, discusses the role of talimogene laherparapvec (T-VEC; Imlygic) in the treatment of patients with melanoma.
 

Dr. Andtbacka Discusses the Role of T-VEC in Melanoma

Robert Andtbacka, MD, associate professor in the Division of Surgial Oncology, Department of Surgery at the University of Utah School of Medicine, discusses the long-term follow-up of overall survival data from the phase III OPTiM study of taglimogene laherparepvec (T-VEC) for patients with metastatic melanoma.

In the OPTiM trial, patients were randomized to receive T-VEC or a subcutaneous GM-CSF. The primary endpoint was durable response rate, which was reported previously, explains Andtbacka. Patients who received T-VEC acheieved a high durable response rate.

A secondary endpoint of this study was overall survival which was met in this patient population, states Andtbacka.

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Robert Andtbacka, MD

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