Skin cancer: Re-engineered herpes virus may improve melanoma treatment

Evan Walker
Evan Walker TheMediTary.Com |
An image collage of herpes virus and cancer cellsShare on Pinterest
Researchers used a genetically modified herpes virus to treat advanced melanoma in a recent phase 2 clinical trial. Design by MNT; Photography by Smith Collection/Gado/Getty Images
  • Advanced melanoma patients often face a risk of recurrence postsurgery.
  • New approaches, like immunotherapies before surgery, could potentially help improve the body’s ability to fight cancer and improve patient outcomes.
  • An innovative approach using a genetically modified herpes virus, known as Talimogene laherparepvec (T-VEC), is gaining traction as it directs immune cells to attack cancer cells, potentially revolutionizing melanoma treatment.

In a phase 2 clinical trial, researchers examined an innovative approach using a genetically modified herpes virus to treat advanced melanoma. The findings were published in JAMA Oncology

The study involved 150 patients with advanced melanoma from various places worldwide.

The Talimogene laherparepvec (T-VEC) is designed to infect and replicate within tumor cells and attract immune cells like T cells and natural killer cells to attack cancer.

The patients they included had a specific type of melanoma that could be surgically removed and had one or more tumors that could be injected with the treatment.

The researchers divided the patients into two groups: one group received injections of neoadjuvant T-VEC followed by surgery (group 1), and the other group had surgery alone without the treatment (group 2).

Dr. Trevan Fischer, surgical oncologist and assistant professor of surgical oncology for Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA, not involved in this research, told Medical News Today that “intralesional therapy has been around for decades. This genetically modified virus has several advantages that make it an attractive research therapeutic option. This data reports the final report at 5 years showing an added benefit to using T-VEC before surgery.”

However, “many things have changed in the field of melanoma since this trial began in 2015,” Dr. Fischer pointed out.

“New and effective systemic agents have been developed and approved. In 2023, it’s rare anyone would use T-VEC and surgery alone with these advances and identifying who may need intralesional therapy to turn a “cold tumor into a hot tumor” is research that is needed and ongoing.”

– Dr. Trevan Fischer

MNT also spoke with Dr. Wael Harb, hematologist and medical oncologist at Memorial Care Cancer Institute at Orange Coast Medical Center in Fountain Valley, CA,and Vice President of Medical Affairs at Syneos Health, not involved in the research.

Dr. Harb said the “research represents a significant stride in understanding the role and efficacy of neoadjuvant therapies for advanced melanoma.”

“The results underscore the potential of combining T-VEC, an oncolytic virus, with surgical interventions to achieve better Recurrence-Free Survival (RFS) and Overall Survival (OS) rates. Adhering to the CONSORT guidelines, the study is a testament to methodological rigor and provides crucial insights into a burgeoning area of melanoma treatment.”

– Dr. Wael Harb

Dr. Harb noted how “the demonstrated improvement in RFS and OS suggests that the combination of neoadjuvant T-VEC and surgery might offer a more potent therapeutic regimen for melanoma patients, especially those at the specified stages.”

In addition, “it adds another dimension to the therapeutic choices clinicians have at their disposal,” Dr. Harb explained.

“While the paper brings forth optimism, it also highlights some limitations, like its smaller sample size and lack of control arms for neoadjuvant Immune Checkpoint Inhibitors (ICIs) or T-VEC combinations. This calls for more comprehensive studies, potentially phase 3 randomized trials, to ascertain these findings’ generalizability.

The study also nudges towards exploring the synergistic effects of combining T-VEC with adjuvant immunotherapy or BRAF inhibitors, a direction that could be immensely fruitful given the evolving landscape of melanoma therapeutics.”

– Dr. Wael Harb

Another important implication of this research is how it can help to raise hope and awareness.

“Such research shines a beacon of progress, enlightening the general public about melanoma treatment advancements,” Dr. Harb pointed out.

“For patients and their loved ones, it represents a beacon of hope, signifying strides towards improved survival rates and enhanced life quality.”

Dr. Harb concluded, “This paper accentuates the importance of integrating innovative therapeutic agents with traditional surgical procedures.”

“While we celebrate these findings, they also serve as a clarion call for further in-depth research, ensuring that we continue to refine our treatment approaches for the betterment of melanoma patients.”

Share this Article