Liver transplant patient with in-transit squamous cell carcinoma treated with talimogene laherparepvec

Lebhar, Jamie; Jacobs, Jennifer M.; Faraz, Khushnood; Salama, April K.S.; Mosca, Paul J.

doi:10.1016/j.jdcr.2023.07.033

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…The mechanism of action aims to selectively replicate the virus and propagate it in tumor cells to increase antigen presentation on MHC-I cells, allowing for more tumor-antigen presentation by dendritic cells [97]. TVEC was shown to temporize the advancement of a cSCC in a SOTR in one case report, and ongoing investigations through Phase Ib/Phase II trials are currently underway to further examine its utility [98][99][100]. Table 2 provides a comprehensive summary of the more recent therapies for cSCC as discussed above.…”

Section: Other Emerging Therapiesmentioning

confidence: 99%

Cutaneous Squamous Cell Carcinoma: An Updated Review

Jiang,

Fritz,

Que

2024

Cancers

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Representing the second most common skin cancer, the incidence and disease burden of cutaneous squamous cell carcinoma (cSCC) continues to increase. Surgical excision of the primary site effectively cures the majority of cSCC cases. However, an aggressive subset of cSCC persists with clinicopathological features that are indicative of higher recurrence, metastasis, and mortality risks. Acceleration of these features is driven by a combination of genetic and environmental factors. The past several years have seen remarkable progress in shaping the treatment landscape for advanced cSCC. Risk stratification and clinical management is a top priority. This review provides an overview of the current perspectives on cSCC with a focus on staging, treatment, and maintenance strategies, along with future research directions.

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Section: Other Emerging Therapiesmentioning

confidence: 99%

Cutaneous Squamous Cell Carcinoma: An Updated Review

Jiang,

Fritz,

Que

2024

Cancers

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“…Talimogene laparhevec (T-VEC) is a herpes virus 1 oncolytic immunological agent approved for the treatment of metastatic melanoma by the FDA and EMA. There are some reports of its use in transplant patients with cSCC who are not candidates for immunotherapy due to the risk of graft rejection, two of them in liver transplant recipients with in-transit and metastatic cSCC and one in a renal transplant patient with multiple cSCCs, with good tolerance and clinical response [ 144 , 145 , 146 ]. T-VEC could be a promising treatment, especially for this subset of patients whose cSCC management is limited by the survival of the graft.…”

Section: Emerging Treatments and Future Directionsmentioning

confidence: 99%

“…T-VEC could be a promising treatment, especially for this subset of patients whose cSCC management is limited by the survival of the graft. It causes a local and systemic immunological response which not only would treat the injected lesions but could prevent the development of new cSCCs in this high-risk population subgroup [ 144 , 145 , 146 ]. Another phase 1 study of T-VEC in locally advanced cutaneous lymphomas and nonmelanoma skin cancers included one patient with locally advanced cSCC.…”

Section: Emerging Treatments and Future Directionsmentioning

confidence: 99%

Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma

Baeza-Hernández,

Cañueto

2023

Cancers

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Cutaneous squamous cell carcinoma (cSCC) is the second most frequent cancer in humans and has the potential to progress locally, metastasize, and cause death in a subset of patients. cSCC is especially common in the elderly, and it will probably represent a major health concern in the near future. Surgery is the standard treatment for cSCC, but intralesional therapies can sometimes be considered for certain patients and under certain circumstances. The choice of intralesional treatment depends on the patient′s characteristics and the clinician′s previous experience and expertise. Here we are reviewing intralesional treatments for cSCC and keratoacanthoma (KA). We have started with some classic drugs, such as methotrexate and 5-fluorouracil, bleomycin, interferon, and cryosurgery, but also comment on electrochemotherapy. Finally, we have focused on novel therapies, some of which are under development, and future perspectives, including intralesional immunotherapy and oncolytic viruses.

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“…In addition, there are only rarely reported cases of T-VEC administration in heart 12 or in combined heart and kidney transplant patients 10 with inoperable recurrent melanoma. To date, only three cases of cSCC with T-VEC therapy in liver or kidney SOT patients have been previously reported 1 , 13 , 14 . In the first case study regarding a liver transplant patient with cSCC, immunosuppression was limited to a single treatment of low-dose mycophenolate mofetil (MMF) 250 mg twice daily without the concomitant use of calcineurin inhibitor (CNI) or corticosteroids (CS) and the patient achieved a complete and sustained remission after T-VEC therapy 1 .…”

Section: Introductionmentioning

confidence: 99%

Primary prophylaxis with mTOR inhibitor enhances T cell effector function and prevents heart transplant rejection during talimogene laherparepvec therapy of squamous cell carcinoma

Joo,

Abdelhamid,

Noto

et al. 2024

Nat Commun

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The application of mammalian target of rapamycin inhibition (mTORi) as primary prophylactic therapy to optimize T cell effector function while preserving allograft tolerance remains challenging. Here, we present a comprehensive two-step therapeutic approach in a male patient with metastatic cutaneous squamous cell carcinoma and heart transplantation followed with concomitant longitudinal analysis of systemic immunologic changes. In the first step, calcineurin inhibitor/ mycophenolic acid is replaced by the mTORi everolimus to achieve an improved effector T cell status with increased cytotoxic activity (perforin, granzyme), enhanced proliferation (Ki67) and upregulated activation markers (CD38, CD69). In the second step, talimogene laherparepvec (T-VEC) injection further enhances effector function by switching CD4 and CD8 cells from central memory to effector memory profiles, enhancing Th1 responses, and boosting cytotoxic and proliferative activities. In addition, cytokine release (IL-6, IL-18, sCD25, CCL-2, CCL-4) is enhanced and the frequency of circulating regulatory T cells is increased. Notably, no histologic signs of allograft rejection are observed in consecutive end-myocardial biopsies. These findings provide valuable insights into the dynamics of T cell activation and differentiation and suggest that timely initiation of mTORi-based primary prophylaxis may provide a dual benefit of revitalizing T cell function while maintaining allograft tolerance.

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Liver transplant patient with in-transit squamous cell carcinoma treated with talimogene laherparepvec

Cited by 4 publications

References 8 publications

Cutaneous Squamous Cell Carcinoma: An Updated Review

Cutaneous Squamous Cell Carcinoma: An Updated Review

Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma

Primary prophylaxis with mTOR inhibitor enhances T cell effector function and prevents heart transplant rejection during talimogene laherparepvec therapy of squamous cell carcinoma

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