A single institution experience using ultrasound-guided intralesional immunotherapy in recurrent melanoma

Intralesional therapy for recurrent melanoma is well-established for palpable lesions, however the benefit of ultrasound-guided (US) injections for non-palpable melanoma has not been well-established. This study evaluates the safety and efficacy of US-guided injection of talimogene laherparepvec (T-VEC) in the treatment of recurrent melanoma. A single-institution retrospective chart review was conducted of patients who received T-VEC between 2018 and 2023. T-tests, Fisher’s exact tests and Chi-squared tests compared patient and treatment characteristics, side effects and outcomes between US-guided and non-US guided injections. Of 36 patients, 11 (31 %) underwent US-guided and 25 (69 %) underwent non-US-guided T-VEC injections. The most common side effects in both groups were fever and chills. The US-guided cohort had no local or systemic complications while the non-US guided group had three patients with complications. Similar response (complete or partial) rates (63.6 % US guided vs 60 % non-US guided) and progression (36.4 % US-guided vs 36 % non-US guided) occurred among the cohorts (p = 0.8). Six-month survival after starting T-VEC treatment was 72.7 % in US-guided and 76 % in non-US guided (p = 0.84). US-guided injections for non-palpable recurrent melanoma are safe and demonstrate similar efficacy to non-US-guided injections, which increases treatment options for some patients.