Melanoma is an aggressive malignancy and has been approached by pathway blockers, BRAF V600, and via immune therapy, including targeting PD-1. As we had discussed two years ago, T-VEC, a viral based therapeutic, had significant potential. The FDA has approved its use yesterday for melanoma. This means that we now have three axes to deal with melanoma; pathways, immunologic, and viral. All three are malignant cell specific and one suspects that a combination therapy may be best, one yet to be determined.
In OncLive states:
Although the current review is for single-agent use,
multiple clinical trials are currently assessing T-VEC in combination with
immune checkpoint inhibitors. A phase II randomized study is ongoing that will
evaluate the safety and efficacy of T-VEC in combination with ipilimumab versus
ipilimumab alone. Additionally, other ongoing clinical trials will investigate
T-VEC in combination with immune checkpoint inhibiting antibodies, such as
those targeting PD-1.
This tripartite approach is worth following.