Talimogene laherparepvec in advanced melanoma

Introduction: Melanoma is the most aggressive of the cutaneous malignancies. Treatment options for advanced melanoma have greatly expanded through the development of immune checkpoint inhibitors and small molecule targeting agents. The most recently approved therapy, talimogene laherparepvec (Imlygic™, OncoVEX^GM-CSF, T-VEC), is a genetically modified herpes simplex virus type 1 that has demonstrated clinical activity in advanced melanoma. This first in class oncolytic virus immunotherapy represents a step forward for the promising class of oncolytic virus therapies. Areas covered: The article reviews melanoma treatment with a focus on the novel oncolytic virus therapy and the preclinical and clinical evidence for treatment of advanced melanoma with T-VEC. The focus for clinical evidence will be on a phase III study of T-VEC in patients with stage IIIB, IIIC or IV melanoma, as well as the phase I and II studies. We also explore the future use of T-VEC in combination with other immunotherapy agents. Finally, we will briefly review issues surrounding the dosing and administration of T-VEC. Expert opinion: Talimogene laherparepvec is a promising therapy in the treatment of patients with advanced melanoma. Increasing evidence suggests T-VEC may also have a role in combination with immune checkpoint inhibitors in the near future.