Single agent Talimogene Laherparepvec for stage IIIB-IVM1c melanoma patients: A systematic review and meta-analysis. (July 2022)

• Record Type: Journal Article
• Authors: Stahlie, Emma H.A.; Mulder, Evalyn E.A.P.; Reijers, Sophie; Balduzzi, Sara; Zuur, Charlotte L.; Klop, Willem M.C.; van der Hiel, Bernies; Van de Wiel, Bart A.; Wouters, Michel W.J.M.; Schrage, Yvonne M.; van Houdt, Winan J.; Grunhagen, Dirk J.; van Akkooi, Alexander C.J.
• Is Part Of: Critical reviews in oncology/hematology. Volume 175(2022)
• Publication Date: 2022-07
• Subjects: Melanoma -- Immunotherapy -- T-VEC -- Metastatic; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2022.103705
• Languages: English
• ISSNs: 1040-8428

Abstract

Abstract: Single-agent Talimogene Laherparepvec (T-VEC) was developed for treatment of unresectable and injectable stage III-IV melanoma. Since its approval and reimbursement, studies have reported varying response rates. The purpose of this systematic review and meta-analysis was to investigate the efficacy and safety of T-VEC. Of 341 publications that were identified, eight studies with a total of 642 patients were included. In patients with stage IIIB-IVM1a, the pooled complete- and overall response rate (CRR and ORR) were 41% and 64%, respectively. In patients with stage IIIB-IVM1c, the pooled CRR and ORR were 30% and 44%, respectively. In patients with stage IVM1b and IVM1c, the pooled CRR and ORR were 4% and 9%, respectively. Adverse events (AEs) were seen in 41–100% of all patients and 0–11% of AEs were severe. In conclusion, single agent T-VEC achieves the highest response rates in patients with early metastatic melanoma and is well-tolerated with generally only mild toxicities. Graphical Abstract: ga1 Highlights: Studies report varying response rates and adverse events to single agent T-VEC. Pooled CRR and ORR were 41% and 64%, respectively, in stage IIIB-IVM1a melanoma. Pooled CRR and ORR were 4% and 9%, respectively, in stage IVM1b-c melanoma. T-VEC achieves the highest response rates in patients with early metastatic disease. T-VEC is generally well-tolerated with only mild toxicity.