Comparative real-world outcomes of stage III melanoma patients treated with talimogene laherparepvec or interleukin 2

Background: Talimogene laherparepvec (T-VEC) and interleukin-2 (IL-2) are both used in the intralesional treatment of melanoma skin metastases. T-VEC received regulatory approval from the European Medicines Agency and the U.S. Food and Drug Administration in 2015, while IL-2 has been used off-label for this purpose for many years. Despite their use in clinical practice, there is a lack of comparative data on the efficacy and safety of these treatments. Objectives: This retrospective study aimed to compare the efficacy and safety of intralesional T-VEC and IL-2 in non-resectable stage III patients with melanoma treated at a single center between January 2016 and September 2024. Methods: We identified eligible patients using the Central Malignant Melanoma Registry and the local University Hospital Pharmacy database. Overall survival (OS) and progression-free survival (PFS) were calculated. Furthermore, best response rates and occurrence of adverse events (AEs) were compared between the T-VEC and the IL-2 group. Concomitant systemic treatment was allowed. Results: A total of 62 patients were included, with 37 receiving T-VEC and 25 receiving IL-2 as first-line therapy. Ten patients received both therapies subsequently. The median PFS for the cohort was 5.0 months, and the median OS was 34.0 months. No significant differences in PFS ( = 0.790), OS ( = 0.894), or best response rates ( = 0.468) were found between groups. Common AEs included local injection site reactions and fever, with no severe events leading to discontinuation by a physician. Conclusion: No significant differences in PFS, OS, or best response rates were observed between IL-2 and T-VEC treatments. The choice of therapy may be influenced by factors such as availability, physician preference, and patient-specific considerations. Study comparing real-world survival and treatment response in stage III melanoma patients using talimogene laherparepvec or interleukin 2 Why was the study done? Talimogene laherparepvec (T-VEC) and interleukin-2 (IL-2) are both used for the intralesional treatment of melanoma skin metastases. T-VEC received regulatory approval from the European Medicines Agency and the U.S. Food and Drug Administration in 2015. In contrast, IL-2 has been used off-label for this purpose for many years but lacks official approval. Despite their concurrent use in clinical practice, there is limited data directly comparing the efficacy and safety of these treatments. What did the researchers do? This retrospective study compared the efficacy and safety of intralesional T-VEC and IL-2 in patients with non-resectable stage III melanoma. The patients were treated at a single center between January 2016 and September 2024. Researchers identified eligible patients using data from the Central Malignant Melanoma Registry and the local University Hospital Pharmacy database. They calculated overall survival (OS) and progression-free survival (PFS) for these patients. Additionally, the study compared the best response rates and the occurrence of adverse events between the T-VEC and IL-2 groups. What did the researchers find? A total of 62 patients were included in the study: 37 received intralesional T-VEC treatment, and 25 received IL-2 treatment as first-line therapy. Additionally, 10 patients received both therapies sequentially. The median progression-free survival (PFS) for the cohort was 5.0 months, and the median overall survival (OS) was 34.0 months. No significant differences were observed between the two groups in terms of PFS ( = 0.790), OS ( = 0.894), or best response rates ( = 0.468). Common adverse events included local injection site reactions and fever. No severe adverse events were observed, and consequently, no treatments had to be discontinued by a physician. What do the findings mean? No significant differences in PFS, OS or best response rates were observed between IL-2 and T-VEC treatments.