Positron emission tomography/computed tomography evaluation of oncolytic virus therapy efficacy in melanoma

Franke, Viola; Hiel, Bernies van der; Wiel, Bart A. van de; Klop, W. Martin C.; Meulen, Sylvia ter; Akkooi, Alexander C. J. van

doi:10.1016/j.ejca.2017.11.007

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…Response evaluation was conducted clinically, by periodic (3‐monthly) PET‐CT and with histological biopsies . Patients received a Median of 2 PET‐CT scans per patient (Range 1–5) and a Median of 0 biopsies per patient (Range 0–4).…”

Section: Resultsmentioning

confidence: 99%

“…Response evaluation was conducted clinically, by periodic (3-monthly) PET-CT and with histological biopsies. 5 Patients received a Median of 2 PET-CT scans per patient (Range 1-5) and a Median of 0 biopsies per patient (Range 0-4). In 11 cases, biopsies of injected ITM localizations were taken to confirm a PET-CT proven complete response, which was confirmed in all 11 cases.…”

Section: Resultsmentioning

confidence: 99%

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High response rates for T‐VEC in early metastatic melanoma (stage IIIB/C‐IVM1a)

Franke

Berger

Klop

et al. 2019

Intl Journal of Cancer

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Talimogene laherparepvec (T‐VEC) is a modified herpes simplex virus, type 1 (HSV‐1), which can be administered intralesionally in patients with stage IIIB/C‐IVM1a unresectable melanoma (EMA label). The phase 3 OPTiM registration study showed an overall response rate (ORR) of 26%. Since December 2016, 48 eligible patients started treatment at the Netherlands Cancer Institute. We included 26 patients in this study with a follow up time ≥6 months, reporting Overall Response Rate (ORR), Disease Control Rate (DCR), Adverse Events (AE), prior treatment for melanoma and baseline characteristics, documented in a prospectively maintained database. In house developed treatment protocol consists of clinical evaluation, periodic PET‐CT and histological biopsies for response evaluation. Median follow‐up was 12.5 months. Of 26 patients, 16 (61.5%) had a Complete Response (CR) as their best response. Seven (26.9%) patients had a Partial Response (PR) as their best response, 1 (3.8%) patient Stable Disease (SD) and 2 (7.7%) patients Progressive Disease (PD). Best ORR was 88.5%. DCR was 92.3%. Grade 1–2 AEs occurred in all patients. Mostly, these consisted of fatigue, influenza‐like symptoms and injection site erythema. All patients underwent prior treatment. Prior treatment did not influence response or toxicity of T‐VEC. Best ORR for T‐VEC monotherapy at our institute was 88.5% with 61.5% achieving a CR. This prospective study for T‐VEC in early metastatic (stage IIIB/C‐IVM1a) melanoma demonstrated superior results to the phase 3 OPTiM study and confirms the role of oncolytic immunotherapy for melanoma.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

High response rates for T‐VEC in early metastatic melanoma (stage IIIB/C‐IVM1a)

Franke

Berger

Klop

et al. 2019

Intl Journal of Cancer

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“…18 F-FDG PET/CT and histological biopsies proved to be clinically useful tools to evaluate treatment response for T-VEC monotherapy [10], confirming pCR or PD to advanced stage IV disease requiring systemic treatment.…”

Section: Resultsmentioning

confidence: 99%

Talimogene laherparepvec monotherapy for head and neck melanoma patients

Franke¹,

Stahlie²,

Klop³

et al. 2022

Melanoma Research

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Talimogene laherparepvec (T-VEC) is a modified herpes simplex virus, type 1, intralesionally administered in patients with stage IIIB/C-IVM1a unresectable melanoma. When surgery is not a treatment option in the head and neck region, T-VEC can be an elegant alternative to systemic immunotherapy. Ten patients with metastatic melanoma in the head and neck region started treatment with T-VEC monotherapy at the Netherlands Cancer Institute. We collected data on response, adverse events (AEs), and baseline characteristics. For response evaluation, we used clinical evaluation with photography, 3-monthly PET/computed tomography (PET/CT) using 18F-fluoro-2-D-deoxyglucose, and histological biopsies. Median age at baseline was 78.2 (35–97) years with a median follow-up of 11.6months. Of these 10 patients, 5 had a complete response (CR), 3 had a partial response, 1 had stable disease and 1 showed progressive disease (PD) as their best response. Best overall response rate (ORR) was 80%. Median progression-free survival was 10.8 months (95% confidence interval, 2.2–19.4). Grade 1 AEs occurred in all patients. Mostly, these consisted of fatigue, influenza-like symptoms, and injection site pain. PET-CT and histological biopsies proved to be clinically useful tools to evaluate treatment response for T-VEC monotherapy, confirming pCR or PD to stage IV disease requiring systemic treatment. ORR for T-VEC monotherapy for melanoma in the head and neck region at our institute was 80% with 50% achieving a CR. This realworld data demonstrates promising results and suggests T-VEC can be an alternative to systemic therapy in this select, mostly elderly patient population.

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“…Since FDG‐PET/CT has a high sensitivity for advanced melanoma, 12 , 13 it is often applied for early detection of (distant) metastasis during treatment with T‐VEC. 14 In addition, FDG‐PET/CT can guide the discontinuation of T‐VEC since the complete metabolic response on FDG‐PET/CT is indicative of a complete pathological response during T‐VEC. 14 On the other hand, the development of new FDG avid lesions suggests progressive disease, requiring another treatment strategy.…”

Section: Introductionmentioning

confidence: 99%

“… 14 In addition, FDG‐PET/CT can guide the discontinuation of T‐VEC since the complete metabolic response on FDG‐PET/CT is indicative of a complete pathological response during T‐VEC. 14 On the other hand, the development of new FDG avid lesions suggests progressive disease, requiring another treatment strategy. However, tumor responses during immunomodulatory treatments are associated with development of immune infiltrates, which can also cause increased FDG uptake.…”

Section: Introductionmentioning

confidence: 99%

False positive FDG uptake in melanoma patients treated with talimogene laherparepvec (T‐VEC)

Mulder

Stahlie

Verver

et al. 2021

Journal of Surgical Oncology

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Talimogene laherparepvec (T-VEC) is a genetically modified herpes simplex virus-1based oncolytic immunotherapy and has been approved for the local treatment of unresectable (stage IIIB/C and IVM1a) cutaneous melanoma. During T-VEC treatment, tumor response is often evaluated using [18F]2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT). In a Dutch cohort (n = 173), almost one-third of patients developed new-onset FDG uptake in uninjected locoregional lymph nodes during T-VEC. In 36 out of 53 (68%) patients with new nodal FDG uptake, nuclear medicine physicians classified this FDG uptake as "suspected metastases" without clinical or pathological confirmation in the majority of patients. These false positive results indicate that new-onset FDG uptake in locoregional lymph nodes during T-VEC treatment does not necessarily reflect progressive disease, but may be associated with immune infiltration. In current clinical practice, physicians should be aware of the high false positive rate of FDG uptake during treatment with T-VEC in patients with melanoma. Therefore, pathological examination of lymph node lesions with new FDG uptake is recommended to differentiate between progressive disease and immune infiltration after treatment with T-VEC.

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Positron emission tomography/computed tomography evaluation of oncolytic virus therapy efficacy in melanoma

Cited by 4 publications

References 17 publications

High response rates for T‐VEC in early metastatic melanoma (stage IIIB/C‐IVM1a)

High response rates for T‐VEC in early metastatic melanoma (stage IIIB/C‐IVM1a)

Talimogene laherparepvec monotherapy for head and neck melanoma patients

False positive FDG uptake in melanoma patients treated with talimogene laherparepvec (T‐VEC)

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